Clinical spectrum, risk factors and outcome of immune reconstitution inflammatory syndrome in patients with tuberculosis-HIV coinfection

William Worodria, Joris Menten, Marguerite Massinga Loembé, Doreen Mazakpwe, D. Bagenda, Olivier Koole, Harriet Mayanja-Kizza, Luc Kestens, Roy D. Mugerwa, Peter Reiss, Robert Colebunders, Rafael Van Den Bergh

Onderzoeksoutput: Articlepeer review

29 Citaten (Scopus)

Samenvatting

BACKGROUND: Here, we aimed to determine the clinical spectrum, predictors and outcomes of paradoxical tuberculosis-immune reconstitution inflammatory syndrome (TB-IRIS) in a resource-limited setting.

METHODS: In a prospective cohort, we studied 254 patients with tuberculosis and HIV coinfection commencing antiretroviral therapy (ART). We identified patients with TB-IRIS using the International Network for Studies Against HIV-Associated IRIS (INSHI) case definition. Risk factors and clinical outcomes of TB-IRIS were determined and reported.

RESULTS: A total of 53 (21%) patients developed TB-IRIS a median of 2 weeks (IQR 12-22 days) after starting ART. The majority of the patients (70%) with TB-IRIS had extrapulmonary manifestations of TB-IRIS. In a multiple logistic regression model, baseline haemoglobin
CONCLUSIONS: TB-IRIS was a frequent reason for clinical deterioration among patients with TB commencing ART but was not a primary contributor to mortality. Patients with advanced CD4 depletion and anaemia were at increased risk of TB-IRIS. Some patients developed late-onset TB-IRIS and/or a recurrent TB-IRIS episode.
Originele taal-2English
Pagina's (van-tot)841-848
TijdschriftAntiviral Therapy
Volume17
StatusPublished - 27 apr 2012

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