Melzani A, de Reynal de Saint Michel R, Ntab B, et al. - Via undertaking a retrospective multicenter study in French Guiana from January 1, 1997, to September 30, 2017, researchers sought to delineate the incidence and features of histoplasmosis-associated immune reconstitution inflammatory syndrome (IRIS) in a cohort of people living with human immunodeficiency virus (PLHIV). Inclusion of 22 patients with histoplasmosis-associated IRIS was done (14 infectious/unmasking and 8 paradoxical). The overall incidence rate was 0.74 cases per 1,000 HIV-infected person-years (95% confidence interval, 0.43–1.05). The mean age was 40.5 years; male to female ratio was 1:4. After antiretroviral therapy initiation, the median time to IRIS was 11 days (interquartile range 7–40 days). Fever, without any specific pattern, and disseminated disease was the main clinical presentation. The literature yielded data from 22 cases with similar characteristics. Findings here suggest a low incidence of histoplasmosis-associated IRIS but it caused significant morbidity in PLHIV. They recommend performing screening for latent or subclinical histoplasmosis in endemic areas before antiretroviral therapy initiation.