PMID- 26073306
OWN - NLM
STAT- MEDLINE
DCOM- 20160915
LR  - 20191219
IS  - 1099-0496 (Electronic)
IS  - 8755-6863 (Print)
IS  - 1099-0496 (Linking)
VI  - 51
IP  - 2
DP  - 2016 Feb
TI  - Paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome 
      in children.
PG  - 157-64
LID - 10.1002/ppul.23221 [doi]
AB  - BACKGROUND: Paradoxical tuberculosis (TB)-associated Immune Reconstitution 
      Inflammatory Syndrome (IRIS) is a common complication of combination 
      antiretroviral treatment (cART) initiation in adults residing in resource-limited 
      regions. Little is known about the burden and presentation of TB-IRIS in children 
      initiating cART while receiving TB treatment. METHODS: Prospective cohort study 
      of South African children initiating cART while on TB treatment. Children were 
      assessed clinically and by chest x-ray before starting cART and at 2, 4, 6, and 
      12 weeks post cART initiation. All children who presented with any signs or 
      symptoms suggestive of paradoxical TB-IRIS were classified according to the 
      consensus adult TB-IRIS case definition developed by the International Network 
      for Study of HIV-associated IRIS (INSHI) and reviewed by an independent expert 
      panel. RESULTS: In 7 of the 104 children enrolled in the cohort, symptoms and/or 
      clinical or radiological signs suggestive of paradoxical TB-IRIS developed after 
      a median of 14 days of cART. In two of these cases, there was agreement between 
      the INSHI case definition and the expert panel. In an additional 3 cases, the 
      INSHI criteria were fulfilled but the expert panel made an alternative diagnosis 
      of pneumonia (n = 2) and poor adherence to cART (n = 1). CONCLUSIONS: The burden 
      of paradoxical TB-IRIS in children with underlying TB initiating cART is low. 
      Including response to antibiotic treatment for pneumonia as a criterion for an 
      alternative diagnosis may improve the specificity of the INSHI case definition.
CI  - (c) 2015 Wiley Periodicals, Inc.
FAU - Van Rie, Annelies
AU  - Van Rie A
AD  - Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel 
      Hill, North Carolina.
FAU - Sawry, Shobna
AU  - Sawry S
AD  - University of the Witwatersrand, Faculty of Health Sciences, Wits Reproductive 
      Health and HIV Institute, Johannesburg, South Africa.
FAU - Link-Gelles, Ruth
AU  - Link-Gelles R
AD  - University of the Witwatersrand, Faculty of Health Sciences, Wits Reproductive 
      Health and HIV Institute, Johannesburg, South Africa.
FAU - Madhi, Shabir
AU  - Madhi S
AD  - Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, 
      University of the Witwatersrand, Johannesburg, South Africa.
AD  - National Research Foundation/Department of Science and Technology: Vaccine 
      Preventable Diseases, University of the Witwatersrand, Johannesburg, South 
      Africa.
FAU - Fairlie, Lee
AU  - Fairlie L
AD  - University of the Witwatersrand, Faculty of Health Sciences, Wits Reproductive 
      Health and HIV Institute, Johannesburg, South Africa.
FAU - Verwey, Charl
AU  - Verwey C
AD  - Division of Paediatric Pulmonology, Chris Hani Baragwanath Academic Hospital, 
      Faculty of Health Sciences, University of the Witwatersrand, South Africa.
FAU - Mahomed, Nasreen
AU  - Mahomed N
AD  - Department of Diagnostic Radiology, University of the Witwatersrand, 
      Johannesburg, South Africa.
FAU - Murdoch, David
AU  - Murdoch D
AD  - Department of Medicine, Duke University Medical Center, Durham, North Carolina.
FAU - Moultrie, Harry
AU  - Moultrie H
AD  - University of the Witwatersrand, Faculty of Health Sciences, Wits Reproductive 
      Health and HIV Institute, Johannesburg, South Africa.
LA  - eng
GR  - UL1 TR001111/TR/NCATS NIH HHS/United States
GR  - K01 TW008005/TW/FIC NIH HHS/United States
GR  - UL1 TR002489/TR/NCATS NIH HHS/United States
GR  - 1UL1TR001111/TR/NCATS NIH HHS/United States
GR  - R01 HD058972/HD/NICHD NIH HHS/United States
GR  - TL1 TR001110/TR/NCATS NIH HHS/United States
GR  - K01TW008005/TW/FIC NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20150614
PL  - United States
TA  - Pediatr Pulmonol
JT  - Pediatric pulmonology
JID - 8510590
RN  - 0 (Antitubercular Agents)
RN  - 0 (HIV Protease Inhibitors)
RN  - 2494G1JF75 (Lopinavir)
RN  - O3J8G9O825 (Ritonavir)
SB  - IM
MH  - Antiretroviral Therapy, Highly Active
MH  - Antitubercular Agents/*therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Female
MH  - HIV Infections/complications/*drug therapy
MH  - HIV Protease Inhibitors/*adverse effects
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*chemically induced/immunology
MH  - Infant
MH  - Infant, Newborn
MH  - Lopinavir/adverse effects
MH  - Male
MH  - Prospective Studies
MH  - Ritonavir/adverse effects
MH  - South Africa
MH  - Tuberculosis/*drug therapy/immunology
MH  - Tuberculosis, Lymph Node/drug therapy/immunology
MH  - Tuberculosis, Pulmonary/drug therapy/immunology
PMC - PMC4678030
MID - NIHMS694824
OTO - NOTNLM
OT  - Africa
OT  - HIV
OT  - IRIS
OT  - TB
OT  - antiretroviral treatment
EDAT- 2015/06/16 06:00
MHDA- 2016/09/16 06:00
PMCR- 2017/02/01
CRDT- 2015/06/16 06:00
PHST- 2014/10/08 00:00 [received]
PHST- 2015/04/06 00:00 [revised]
PHST- 2015/04/19 00:00 [accepted]
PHST- 2015/06/16 06:00 [entrez]
PHST- 2015/06/16 06:00 [pubmed]
PHST- 2016/09/16 06:00 [medline]
PHST- 2017/02/01 00:00 [pmc-release]
AID - 10.1002/ppul.23221 [doi]
PST - ppublish
SO  - Pediatr Pulmonol. 2016 Feb;51(2):157-64. doi: 10.1002/ppul.23221. Epub 2015 Jun 
      14.