PMID- 20302011
OWN - NLM
STAT- MEDLINE
DCOM- 20110303
LR  - 20100322
IS  - 0125-2208 (Print)
IS  - 0125-2208 (Linking)
VI  - 93
IP  - 2
DP  - 2010 Feb
TI  - Immune reconstitution inflammatory syndrome in HIV-infected patients with 
      tuberculosis.
PG  - 257-64
AB  - Tuberculosis (TB) remains an important problem in patients with human 
      immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome 
      (AIDS). Concomitant administration therapy of both TB and HIV is fraught with 
      difficulties. Despite the fact that the use of highly active antiretroviral 
      therapy (HAART) led to significant improve quality of life and decrease morbidity 
      including mortality-associated to HIV/AIDS, adverse drug effects lead to 
      interruptions in both HIV and TB therapy. In addition, an important problem when 
      HAART is initiated in patients with TB is the possibility of developing immune 
      reconstitution inflammatory syndrome (IRIS). A six-month regimen consisting of 
      isoniazid, rifampicin, pyrazinamide, and ethambutal for two months followed by 
      isoniazid and rifampicin for four months is a standard regimen for the treatment 
      of known or presumed drug-susceptible TB disease. The following strategy may 
      minimize the risk of IRIS. Patients with CD4 cell counts < 100 cells/mm3, 
      efavirenz-based HAART regimen is recommended and should be initiated as soon as 
      the patients can tolerate TB treatment. Patients with CD4 cell counts 100-350 
      cells/mm3, HAART should be started at two months after TB treatment initiation. 
      HAART should be deferred with closed follow-up of CD4 cell counts if patients 
      have CD4 cell counts > 350 cells/mm3.
FAU - Kiertiburanakul, Sasisopin
AU  - Kiertiburanakul S
AD  - Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol 
      University, Bangkok, Thailand. rasal@mahidol.ac.th
LA  - eng
PT  - Journal Article
PL  - Thailand
TA  - J Med Assoc Thai
JT  - Journal of the Medical Association of Thailand = Chotmaihet thangphaet
JID - 7507216
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - Anti-HIV Agents/adverse effects/therapeutic use
MH  - Antiretroviral Therapy, Highly Active/adverse effects
MH  - Antitubercular Agents/therapeutic use
MH  - HIV Infections/*complications/drug therapy
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/chemically induced/drug 
      therapy/*etiology
MH  - Risk Factors
MH  - Tuberculosis, Pulmonary/*complications/drug therapy
RF  - 37
EDAT- 2010/03/23 06:00
MHDA- 2011/03/04 06:00
CRDT- 2010/03/23 06:00
PHST- 2010/03/23 06:00 [entrez]
PHST- 2010/03/23 06:00 [pubmed]
PHST- 2011/03/04 06:00 [medline]
PST - ppublish
SO  - J Med Assoc Thai. 2010 Feb;93(2):257-64.