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 (11%) as that reported in previous studies from resource-limited settings (8%-13%). This case definition should be evaluated prospectively.
| Original language | English |
|---|---|
| Journal | Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002) |
| Volume | 9 |
| Issue number | 2 |
| Pages (from-to) | 104-8 |
| Number of pages | 5 |
| ISSN | 1545-1097 |
| DOIs | |
| Publication status | Published - 2010 |
Keywords
- AIDS-Related Opportunistic Infections/immunology
- Adult
- Anti-HIV Agents/therapeutic use
- CD4 Lymphocyte Count
- Cohort Studies
- Developing Countries
- Female
- HIV Infections/complications
- HIV-1
- Humans
- Immune Reconstitution Inflammatory Syndrome/etiology
- Male
- Mycobacterium tuberculosis
- Reference Standards
- Retrospective Studies
- South Africa
- Tuberculosis/complications