Evaluation of paradoxical TB-associated IRIS with the use of standardized case definitions for resource-limited settings
Date
2010
Authors
Eshun-Wilson I.
Havers F.
Nachega J.B.
Prozesky H.W.
Taljaard J.J.
Zeier M.D.
Cotton M.
Simon G.
Soentjens P.
Journal Title
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Volume Title
Publisher
Abstract
Objective: Standardized case definitions have recently been proposed by the International Network for the Study of HIV-associated immune reconstitution inflammatory syndrome (INSHI; [IRIS]) for use in resource-limited settings. We evaluated paradoxical tuberculosis (TB)-associated IRIS in a large cohort from a TB endemic setting with the use of these case definitions. Design: A retrospective cohort study. Method: We reviewed records from 1250 South African patients who initiated antiretroviral therapy (ART) over a 5-year period. Results: A total of 333 (27%) of the patients in the cohort had prevalent TB at the initiation of ART. Of 54 possible paradoxical TB-associated IRIS cases, 35 fulfilled the INSHI case definitions (11% of TB cases). Conclusions: INSHI-standardized case definitions were used successfully in identifying paradoxical TB-associated IRIS in this cohort and resulted in a similar proportion of TB IRIS cases ( %) as that reported in previous studies from resource-limited settings (8%-l3%). This case definition should be evaluated prospectively. © The Author(s) 2010.
Description
Keywords
corticosteroid, efavirenz, lamivudine, nevirapine, stavudine, tuberculostatic agent, zidovudine, adult, article, endemic disease, female, health care access, human, Human immunodeficiency virus infection, immune reconstitution inflammatory syndrome, major clinical study, male, paradoxical tuberculosis associated immune reconstitution inflammatory syndrome, prevalence, priority journal, South Africa, standardization, tuberculosis, Adult, AIDS-Related Opportunistic Infections, Anti-HIV Agents, CD4 Lymphocyte Count, Cohort Studies, Developing Countries, Female, HIV Infections, HIV-1, Humans, Immune Reconstitution Inflammatory Syndrome, Male, Mycobacterium tuberculosis, Reference Standards, Retrospective Studies, South Africa, Tuberculosis
Citation
Journal of the International Association of Physicians in AIDS Care
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