PMID- 15282393
OWN - NLM
STAT- MEDLINE
DCOM- 20040831
LR  - 20220331
IS  - 0040-6376 (Print)
IS  - 1468-3296 (Electronic)
IS  - 0040-6376 (Linking)
VI  - 59
IP  - 8
DP  - 2004 Aug
TI  - Paradoxical reactions during tuberculosis treatment in patients with and without 
      HIV co-infection.
PG  - 704-7
AB  - BACKGROUND: It has been suggested that deterioration of tuberculosis (TB) during 
      appropriate treatment, termed a paradoxical reaction (PR), is more common and 
      severe in HIV positive individuals on highly active antiretroviral therapy 
      (HAART). METHOD: A study was undertaken to determine the frequency of PR and its 
      associated features in a population of HIV+TB+ patients and a similar sized group 
      of HIV-TB+ individuals. RESULTS: PR occurred in 28% of 50 HIV+TB+ patients and 
      10% of 50 HIV-TB+ patients. Disseminated TB was present in eight of 13 HIV+TB+ 
      patients and four of five HIV-TB+ patients with PR. In 28 HIV+TB+ patients 
      starting HAART, PR was significantly associated with commencing HAART within 6 
      weeks of starting antituberculosis treatment (p = 0.03) and was more common in 
      those with disseminated TB (p = 0.09). No association was found between 
      development of PR and baseline CD4 count or CD4 response to HAART. CONCLUSIONS: 
      PR is common in HIV infected and uninfected individuals with TB. Early 
      introduction of HAART and the presence of disseminated TB appear to be important 
      in co-infected patients.
FAU - Breen, R A M
AU  - Breen RA
AD  - Department of Thoracic and HIV Medicine, Royal Free Hospital, London NW3 2QG, UK. 
      rambreen@doctors.org.uk
FAU - Smith, C J
AU  - Smith CJ
FAU - Bettinson, H
AU  - Bettinson H
FAU - Dart, S
AU  - Dart S
FAU - Bannister, B
AU  - Bannister B
FAU - Johnson, M A
AU  - Johnson MA
FAU - Lipman, M C I
AU  - Lipman MC
LA  - eng
PT  - Journal Article
PL  - England
TA  - Thorax
JT  - Thorax
JID - 0417353
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Antitubercular Agents)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/complications/drug therapy
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Adult
MH  - *Antiretroviral Therapy, Highly Active
MH  - Antitubercular Agents/*therapeutic use
MH  - C-Reactive Protein/analysis
MH  - Disease Progression
MH  - Female
MH  - HIV Infections/blood/complications/*drug therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Tuberculosis/complications/*drug therapy
PMC - PMC1747098
EDAT- 2004/07/30 05:00
MHDA- 2004/09/01 05:00
PMCR- 2007/08/01
CRDT- 2004/07/30 05:00
PHST- 2004/07/30 05:00 [pubmed]
PHST- 2004/09/01 05:00 [medline]
PHST- 2004/07/30 05:00 [entrez]
PHST- 2007/08/01 00:00 [pmc-release]
AID - 59/8/704 [pii]
AID - 10.1136/thx.2003.019224 [doi]
PST - ppublish
SO  - Thorax. 2004 Aug;59(8):704-7. doi: 10.1136/thx.2003.019224.