PMID- 20571170
OWN - NLM
STAT- MEDLINE
DCOM- 20100920
LR  - 20130418
IS  - 0971-5916 (Print)
IS  - 0971-5916 (Linking)
VI  - 131
DP  - 2010 Jun
TI  - A study of TB-associated immune reconstitution inflammatory syndrome using the 
      consensus case-definition.
PG  - 804-8
AB  - BACKGROUND & OBJECTIVES: A considerable proportion of patients with HIV 
      associated tuberculosis (TB) started on highly active antiretroviral therapy 
      (HAART) develop immune reconstitution inflammatory syndrome (IRIS), which is 
      difficult to diagnose in a resource-limited setting. In view of the recently 
      proposed consensus case-definitions for TB-IRIS for use in resource-limited 
      settings we undertook this study to describe the incidence and risk factors of TB 
      associated IRIS in a tertiary care hospital and research centre in north India. 
      METHODS: Retrospective analysis of antiretroviral treatment (ART) naive adults 
      started on highly active ART (HAART) from June 2006 to September 2008 was done. 
      RESULTS: Of the 627 patients studied, 237 (38%) had TB at the initiation of 
      HAART. In total, 18 (7.5%) of 237 patients with TB at baseline had paradoxical 
      TB-associated IRIS, and 12 (3%) of 390 patients without TB at baseline developed 
      ART-associated TB. Most IRIS events occurred during the initial 30 days of HAART. 
      Two patients developed TB-associated IRIS after 90 days of HAART. Using 
      univariate analysis, low CD4+ cell count at baseline [64 (28-89) vs. 95 (52-150); 
      P=0.009] and early initiation of HAART [33 (24-41) vs. 48 (35-61) days; P<0.001] 
      were significantly associated with paradoxical TB-associated IRIS. No 
      identifiable risk factors were associated with the development of ART-associated 
      TB. INTERPRETATION & CONCLUSION: A considerable proportion of patients on HAART 
      develop TB-associated IRIS. The consensus case-definition is a useful tool in 
      resource-limited settings for the diagnosis of TB- associated IRIS.
FAU - Sharma, Surendra K
AU  - Sharma SK
AD  - Department of Medicine, All India Institute of Medical Sciences, New Delhi, 
      India. sksharma@aiims.ac.in
FAU - Dhooria, Sahajal
AU  - Dhooria S
FAU - Barwad, Parag
AU  - Barwad P
FAU - Kadhiravan, Tamilarasu
AU  - Kadhiravan T
FAU - Ranjan, Sanjay
AU  - Ranjan S
FAU - Miglani, Sunita
AU  - Miglani S
FAU - Gupta, Deepak
AU  - Gupta D
LA  - eng
PT  - Journal Article
PL  - India
TA  - Indian J Med Res
JT  - The Indian journal of medical research
JID - 0374701
SB  - IM
MH  - AIDS-Related Opportunistic Infections/*complications/drug therapy/immunology
MH  - Adult
MH  - Antiretroviral Therapy, Highly Active
MH  - Consensus
MH  - *HIV Infections/complications/drug therapy/immunology
MH  - Humans
MH  - Immune Reconstitution Inflammatory 
      Syndrome/diagnosis/epidemiology/*etiology/immunology
MH  - India/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Tuberculosis/*complications/drug therapy/immunology
EDAT- 2010/06/24 06:00
MHDA- 2010/09/21 06:00
CRDT- 2010/06/24 06:00
PHST- 2010/06/24 06:00 [entrez]
PHST- 2010/06/24 06:00 [pubmed]
PHST- 2010/09/21 06:00 [medline]
PST - ppublish
SO  - Indian J Med Res. 2010 Jun;131:804-8.