PMID- 22218514
OWN - NLM
STAT- MEDLINE
DCOM- 20120927
LR  - 20191027
IS  - 1678-4391 (Electronic)
IS  - 1413-8670 (Linking)
VI  - 15
IP  - 6
DP  - 2011 Nov-Dec
TI  - Incidence and risk factors of immune reconstitution inflammatory syndrome in 
      HIV-TB coinfected patients.
PG  - 553-9
AB  - Tuberculosis is one of the leading causes of development of Immune reconstitution 
      inflammatory syndrome (IRIS) in HIV patients receiving antiretroviral therapy 
      (ART). OBJECTIVE: To determine the incidence of IRIS in HIV-TB coinfected 
      patients, and to find out the possible risk factors associated with IRIS. 
      MATERIALS AND METHODS: Study commenced with 96 patients adhered to standard 
      antitubercular therapy (ATT) and ART without defaulting, and followed up for six 
      months. RESULT: The mean (+/- SD) CD4 count and CD4 percentage at baseline was 
      59.16 (+/- 24.63) per mm(3) and 4.59% (+/- 1.73) respectively. Only 18.75% developed 
      IRIS after 57.05 (+/- 14.12) days of initiation of ART. Extrapulmonary tuberculosis 
      was the most significant factor associated with IRIS (83.33%) than those without 
      IRIS (44.87%) (p = 0.0032). Specifically, tubercular lymphadenitis (38.88%, p = 
      0.0364) and disseminated tuberculosis (33.33%, p = 0.0217) were significantly 
      associated with IRIS. The other risk factors associated with appearance of IRIS 
      were higher CD4 count (p = 0.0212) at three months after initiation of ART and 
      increment of CD4 count (p = 0.0063) and CD4 percentage (p = 0.0016) during this 
      period. The major manifestations of IRIS were fever (40%), followed by 
      lymphadenitis (38%). The mortality rate in IRIS was not higher than those without 
      IRIS. CONCLUSION: Patients with extrapulmonary tuberculosis, especially 
      tubercular lymphadenitis, were more likely to develop IRIS and fever was 
      associated in most of them. Higher increment of CD4 count may indicate 
      development of IRIS in presence of new or worsening tuberculosis lesion.
FAU - Dibyendu, De
AU  - Dibyendu D
AD  - Department of Medicine, Medical College, Kolkata, India. de.dibyendu@gmail.com
FAU - Sarkar, Rathindra Nath
AU  - Sarkar RN
FAU - Phaujdar, Sibaji
AU  - Phaujdar S
FAU - Bhattacharyya, Kuntal
AU  - Bhattacharyya K
FAU - Pal, Hare Krishna
AU  - Pal HK
LA  - eng
PT  - Journal Article
PL  - Brazil
TA  - Braz J Infect Dis
JT  - The Brazilian journal of infectious diseases : an official publication of the 
      Brazilian Society of Infectious Diseases
JID - 9812937
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/*drug therapy/epidemiology
MH  - Adult
MH  - Anti-Retroviral Agents/*adverse effects/therapeutic use
MH  - Antitubercular Agents/*adverse effects/therapeutic use
MH  - CD4 Lymphocyte Count
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*chemically 
      induced/diagnosis/epidemiology
MH  - Incidence
MH  - India/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
MH  - Tuberculosis, Pulmonary/*drug therapy/epidemiology
EDAT- 2012/01/06 06:00
MHDA- 2012/09/28 06:00
CRDT- 2012/01/06 06:00
PHST- 2011/05/03 00:00 [received]
PHST- 2011/07/17 00:00 [accepted]
PHST- 2012/01/06 06:00 [entrez]
PHST- 2012/01/06 06:00 [pubmed]
PHST- 2012/09/28 06:00 [medline]
AID - S1413-8670(11)70250-1 [pii]
AID - 10.1016/s1413-8670(11)70250-1 [doi]
PST - ppublish
SO  - Braz J Infect Dis. 2011 Nov-Dec;15(6):553-9. doi: 10.1016/s1413-8670(11)70250-1.