PMID- 16487593
OWN - NLM
STAT- MEDLINE
DCOM- 20061130
LR  - 20071214
IS  - 1532-2742 (Electronic)
IS  - 0163-4453 (Linking)
VI  - 53
IP  - 6
DP  - 2006 Dec
TI  - Immune reconstitution inflammatory syndrome of tuberculosis among HIV-infected 
      patients receiving antituberculous and antiretroviral therapy.
PG  - 357-63
AB  - OBJECTIVE: To determine the frequency, risk factors and mortality rate of immune 
      reconstitution inflammatory syndrome (IRIS) of tuberculosis (TB) in patients 
      co-infected with HIV/TB and receiving antiretroviral therapy (ART). METHODS: A 
      retrospective study was conducted in Bamrasnaradura Infectious Diseases Institute 
      and Ramathibodi Hospital, Thailand. RESULTS: There were 167 patients with a mean 
      age of 34.5 years. Median (IQR) CD4 cell counts was 36 (15-69) cells/mm(3) and 
      median (IQR) HIV RNA was 427,000 (189,000-750,000) copies/ml. ART was initiated 
      at a median (IQR) duration of 2.2 (1.4-3.7) months after TB treatment. IRIS was 
      identified in 21 (12.6%) patients. Patients with IRIS had a higher proportion of 
      extrapulmonary TB than patients without IRIS (P<0.001). By multivariate analysis, 
      extrapulmonary TB was a risk factor for IRIS (odds ratio=8.225, 95% confidence 
      interval=1.785-37.911, P=0.007). Of 21 patients with IRIS, 15 patients developed 
      IRIS within the first two months of ART. The mortality rate in patients with and 
      without IRIS was not different (9.5% versus 2.1%, P=0.119). CONCLUSIONS: The rate 
      of TB IRIS is 13% in patients co-infected with HIV and TB. Extrapulmonary TB is a 
      risk factor for IRIS. Closely monitored clinical care in the first few months of 
      ART initiation and further interventional studies to minimize mortality of TB 
      IRIS are needed.
FAU - Manosuthi, Weerawat
AU  - Manosuthi W
AD  - Department of Medicine, Bamrasnaradura Infectious Diseases Institute, Ministry of 
      Public Health, Tiwanon Road, Nonthaburi 11000, Thailand. idweerawat@yahoo.com 
      <idweerawat@yahoo.com>
FAU - Kiertiburanakul, Sasisopin
AU  - Kiertiburanakul S
FAU - Phoorisri, Thanongsri
AU  - Phoorisri T
FAU - Sungkanuparph, Somnuek
AU  - Sungkanuparph S
LA  - eng
PT  - Journal Article
DEP - 20060217
PL  - England
TA  - J Infect
JT  - The Journal of infection
JID - 7908424
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/*drug therapy/epidemiology/mortality
MH  - Adult
MH  - Anti-Retroviral Agents/*therapeutic use
MH  - Antitubercular Agents/*therapeutic use
MH  - CD4 Lymphocyte Count
MH  - Female
MH  - HIV Infections/*drug therapy/epidemiology/mortality
MH  - Humans
MH  - Inflammation/complications/etiology/*physiopathology
MH  - Logistic Models
MH  - Male
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Syndrome
MH  - Thailand/epidemiology
MH  - Tuberculosis/*drug therapy/epidemiology/mortality
EDAT- 2006/02/21 09:00
MHDA- 2006/12/09 09:00
CRDT- 2006/02/21 09:00
PHST- 2005/10/21 00:00 [received]
PHST- 2005/12/27 00:00 [revised]
PHST- 2006/01/04 00:00 [accepted]
PHST- 2006/02/21 09:00 [pubmed]
PHST- 2006/12/09 09:00 [medline]
PHST- 2006/02/21 09:00 [entrez]
AID - S0163-4453(06)00006-5 [pii]
AID - 10.1016/j.jinf.2006.01.002 [doi]
PST - ppublish
SO  - J Infect. 2006 Dec;53(6):357-63. doi: 10.1016/j.jinf.2006.01.002. Epub 2006 Feb 
      17.