PMID- 28399724
OWN - NLM
STAT- MEDLINE
DCOM- 20180611
LR  - 20181113
IS  - 2325-9582 (Electronic)
IS  - 2325-9574 (Print)
IS  - 2325-9574 (Linking)
VI  - 16
IP  - 5
DP  - 2017 Sep/Oct
TI  - The Epidemiology of IRIS in Southern India: An Observational Cohort Study.
PG  - 475-480
LID - 10.1177/2325957417702485 [doi]
AB  - Immune reconstitution inflammatory syndrome (IRIS) is an uncommon but dynamic 
      phenomenon seen among patients initiating antiretroviral therapy (ART). We aimed 
      to describe incidence, risk factors, clinical spectrum, and outcomes among 
      ART-naive patients experiencing IRIS in southern India. Among 599 eligible 
      patients monitored prospectively between 2012 and 2014, there were 59.3% males, 
      with mean age 36.6 +/- 7.8 years. Immune reconstitution inflammatory syndrome 
      incidence rate was 51.3 per 100 person-years (95% confidence interval: 
      44.5-59.2). One-third (31.4%) experienced at least 1 IRIS event, at a median of 
      27 days since ART initiation. Mucocutaneous infections and candidiasis were 
      common IRIS events, followed by tuberculosis. Significant risk factors included 
      age >40 years, body mass index <18.5 kg/m(2), CD4 count <100 cells/mm(3), viral 
      load >10 000 copies/mL, hemoglobin <11 g/dL, and erythrocyte sedimentation rate 
      >50 mm/h. Immune reconstitution inflammatory syndrome-related morality was 1.3% 
      (8 of 599); 3 patients died of complicated diarrhea. These findings highlight the 
      current spectrum of IRIS in South India and underscore the importance of 
      heightened vigilance for anemia and treatment of diarrhea and candidiasis during 
      ART initiation.
FAU - Thambuchetty, Nisha
AU  - Thambuchetty N
AD  - 1 Department of General Surgery, Father Muller Medical College Hospital, 
      Mangalore, Karnataka, India.
FAU - Mehta, Kayur
AU  - Mehta K
AD  - 2 Division of Pediatric Infectious Diseases, The Hospital for Sick Children, 
      University of Toronto, Toronto, Ontario, Canada.
FAU - Arumugam, Karthika
AU  - Arumugam K
AD  - 3 Division of Biostatistics, St John's Research Institute, Bangalore, Karnataka, 
      India.
FAU - Shekarappa, Umadevi G
AU  - Shekarappa UG
AD  - 4 Antiretroviral Treatment (ART) Centre, St John's Medical College Hospital, 
      Bangalore, Karnataka, India.
FAU - Idiculla, Jyothi
AU  - Idiculla J
AD  - 5 Department of Medicine, St John's Medical College, Bangalore, Karnataka, India.
FAU - Shet, Anita
AU  - Shet A
AD  - 6 International Vaccine Access Center, Johns Hopkins Bloomberg School of Public 
      Health, Baltimore, MD, USA.
LA  - eng
GR  - Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20170412
PL  - United States
TA  - J Int Assoc Provid AIDS Care
JT  - Journal of the International Association of Providers of AIDS Care
JID - 101603896
SB  - IM
MH  - Adult
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - CD4 Lymphocyte Count
MH  - Female
MH  - HIV Infections/drug therapy/epidemiology/virology
MH  - HIV-1/physiology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*epidemiology/etiology/immunology
MH  - India/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Viral Load
MH  - Young Adult
PMC - PMC5949067
MID - EMS77637
OTO - NOTNLM
OT  - AIDS
OT  - HIV
OT  - IRIS
OT  - anemia
OT  - candidiasis
COIS- Declaration of Conflicting Interests The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2017/04/13 06:00
MHDA- 2018/06/12 06:00
PMCR- 2018/05/12
CRDT- 2017/04/13 06:00
PHST- 2017/04/13 06:00 [pubmed]
PHST- 2018/06/12 06:00 [medline]
PHST- 2017/04/13 06:00 [entrez]
PHST- 2018/05/12 00:00 [pmc-release]
AID - 10.1177/2325957417702485 [doi]
PST - ppublish
SO  - J Int Assoc Provid AIDS Care. 2017 Sep/Oct;16(5):475-480. doi: 
      10.1177/2325957417702485. Epub 2017 Apr 12.