In most studies, TB-IRIS occurs within two months of ART initiation [6, 7, 10, 11, 25, 35, 45, 48] . Among 43 cases of MTB-associated IRIS, the median onset of IRIS was 12-15 days (range 2-114 days), with only four of these cases occurring more than four weeks after the initiation of antiretroviral therapy [7, 10, 25, 26, 30] . These studies suggest the onset of mycobacterial-associated IRIS is relatively soon after initiation of ART, and clinicians should maintain a high level of vigilance during this period.