Evaluation of paradoxical TB-associated IRIS with the use of standardized case definitions for resource-limited settings

Ingrid Eshun-Wilson, Fiona Havers, Jean B Nachega, Hans W Prozesky, Jantjie J Taljaard, Michele D Zeier, Mark Cotton, Gary Simon, Patrick Soentjens

    Research output: Contribution to journalArticlepeer-review

    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 languageEnglish
    JournalJournal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)
    Volume9
    Issue number2
    Pages (from-to)104-8
    Number of pages5
    ISSN1545-1097
    DOIs
    Publication statusPublished - 18-Feb-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

    Fingerprint

    Dive into the research topics of 'Evaluation of paradoxical TB-associated IRIS with the use of standardized case definitions for resource-limited settings'. Together they form a unique fingerprint.

    Cite this