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.
|Journal||Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)|
|Number of pages||5|
|Publication status||Published - 18-Feb-2010|
- AIDS-Related Opportunistic Infections/immunology
- Anti-HIV Agents/therapeutic use
- CD4 Lymphocyte Count
- Cohort Studies
- Developing Countries
- HIV Infections/complications
- Immune Reconstitution Inflammatory Syndrome/etiology
- Mycobacterium tuberculosis
- Reference Standards
- Retrospective Studies
- South Africa