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dc.contributor.authorWorodria, William
dc.contributor.authorMenten, Joris
dc.contributor.authorMassinga-Loembe, Marguerite
dc.contributor.authorMazakpwe, Doreen
dc.contributor.authorBagenda, Danstan
dc.contributor.authorKoole, Olivier
dc.contributor.authorMayanja-Kizza, Harriet
dc.contributor.authorKestens, Luc
dc.contributor.authorMugerwa, Roy
dc.contributor.authorReiss, Peter
dc.contributor.authorColebunders, Robert
dc.contributor.authorThe TB-IRIS study group
dc.date.accessioned2013-01-04T06:34:12Z
dc.date.available2013-01-04T06:34:12Z
dc.date.issued2012
dc.identifier.citationWorodria, W., Menten, J., Massinga-Loembe, M., Mazakpwe, D., Bagenda, D., Koole, O., Mayanja-Kizza, H., Kestens, L., Mugerwa, R., Reiss, P., Colebunders, R., The TB-IRIS study group. (2012). Clinical spectrum, risk factors and outcome of immune reconstitution inflammatory syndrome in patients with tuberculosis-HIV coinfection. Antiviral Therapy , 17en_US
dc.identifier.issn2040-2058
dc.identifier.urihttp://hdl.handle.net/10570/947
dc.description.abstractBACKGROUND: 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 <100 g/l (OR 2.23 [95% CI 1.08-4.60]; P=0.031) and baseline CD4(+) T-cell count <50 cells/μl (OR 4.13 [95% CI 1.80-9.51]; P=0.001) were significant predictors of IRIS. Seven additional patients fulfilled all INSHI criteria of TB-IRIS but had the episode of TB-IRIS later than 3 months after ART start. 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.en_US
dc.language.isoenen_US
dc.publisherInternational Medical Pressen_US
dc.subjectResource limited settingen_US
dc.subjectHIV/AIDSen_US
dc.subjectPulmonary tuberculosisen_US
dc.subjectARTen_US
dc.subjectCD4 Cell Counten_US
dc.subjectTB-HIV coinfectionen_US
dc.titleClinical spectrum, risk factors and outcome of immune reconstitution inflammatory syndrome in patients with tuberculosis-HIV coinfectionen_US
dc.typeJournal article, peer revieweden_US


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