Our definition of Severe-IRIS-KS shares similarities to KICS criteria [53,54], the main difference is the temporal relation to cART initiation, the abrupt initiation of symptoms (fever, increase in SK lesions, lymphedema or pleural effusion, rapid decrease in platelets, Hb, sodium, and albumin) and the response to vincristine/bleomycin [55]. Here, ALB is linked to Pleural effusion.