Clinical Characteristics of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome in North Indian Population of HIV/AIDS Patients Receiving HAART
Background & Objective. IRIS is an important complication that occurs during management of HIV-TB coinfection and it poses difficulty in diagnosis. Previous studies have reported variable incidence of IRIS. The present study was undertaken to describe the pattern of TB-associated IRIS using rece...
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Wiley
2011-01-01
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| Series: | Clinical and Developmental Immunology |
| Online Access: | http://dx.doi.org/10.1155/2011/239021 |
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| author | Suman Karmakar Surendra K. Sharma Richa Vashishtha Abhishek Sharma Sanjay Ranjan Deepak Gupta Vishnubhatla Sreenivas Sanjeev Sinha Ashutosh Biswas Vinay Gulati |
| author_facet | Suman Karmakar Surendra K. Sharma Richa Vashishtha Abhishek Sharma Sanjay Ranjan Deepak Gupta Vishnubhatla Sreenivas Sanjeev Sinha Ashutosh Biswas Vinay Gulati |
| author_sort | Suman Karmakar |
| collection | DOAJ |
| description | Background & Objective. IRIS is an important complication that occurs during management of HIV-TB coinfection and it poses difficulty in diagnosis. Previous studies have reported variable incidence of IRIS. The present study was undertaken to describe the pattern of TB-associated IRIS using recently proposed consensus case-definitions for TB-IRIS for its use in resource-limited settings. Methods. A prospective analysis of ART-naïve adults started on HAART from November, 2008 to May, 2010 was done in a tertiary care hospital in north India. A total 224 patients divided into two groups, one with HIV-TB and the other with HIV alone, were followedup for a minimum period of 3 months. The diagnosis of TB was categorised as ‘‘definitive’’ and ‘‘probable’’. Results. Out of a total of 224 patients, 203 completed followup. Paradoxical TB-IRIS occurred in 5 of 123 (4%) HIV-TB patients while 6 of 80 (7.5%) HIV patients developed ART-associated TB. A reduction in plasma viral load was significantly (P=.016) associated with paradoxical TB-IRIS. No identifiable risk factors were associated with the development of ART-associated TB. Conclusion. The consensus case-definitions are useful tools in the diagnosis of TB-associated IRIS. High index of clinical suspicion is required for an early diagnosis. |
| format | Article |
| id | doaj-art-a389132135104617a9408a258263426c |
| institution | Kabale University |
| issn | 1740-2522 1740-2530 |
| language | English |
| publishDate | 2011-01-01 |
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| series | Clinical and Developmental Immunology |
| spelling | doaj-art-a389132135104617a9408a258263426c2025-02-03T06:06:21ZengWileyClinical and Developmental Immunology1740-25221740-25302011-01-01201110.1155/2011/239021239021Clinical Characteristics of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome in North Indian Population of HIV/AIDS Patients Receiving HAARTSuman Karmakar0Surendra K. Sharma1Richa Vashishtha2Abhishek Sharma3Sanjay Ranjan4Deepak Gupta5Vishnubhatla Sreenivas6Sanjeev Sinha7Ashutosh Biswas8Vinay Gulati9Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaUniversity of Medicine, Pleven, BulgariaDepartment of Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Biostatistics, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaBackground & Objective. IRIS is an important complication that occurs during management of HIV-TB coinfection and it poses difficulty in diagnosis. Previous studies have reported variable incidence of IRIS. The present study was undertaken to describe the pattern of TB-associated IRIS using recently proposed consensus case-definitions for TB-IRIS for its use in resource-limited settings. Methods. A prospective analysis of ART-naïve adults started on HAART from November, 2008 to May, 2010 was done in a tertiary care hospital in north India. A total 224 patients divided into two groups, one with HIV-TB and the other with HIV alone, were followedup for a minimum period of 3 months. The diagnosis of TB was categorised as ‘‘definitive’’ and ‘‘probable’’. Results. Out of a total of 224 patients, 203 completed followup. Paradoxical TB-IRIS occurred in 5 of 123 (4%) HIV-TB patients while 6 of 80 (7.5%) HIV patients developed ART-associated TB. A reduction in plasma viral load was significantly (P=.016) associated with paradoxical TB-IRIS. No identifiable risk factors were associated with the development of ART-associated TB. Conclusion. The consensus case-definitions are useful tools in the diagnosis of TB-associated IRIS. High index of clinical suspicion is required for an early diagnosis.http://dx.doi.org/10.1155/2011/239021 |
| spellingShingle | Suman Karmakar Surendra K. Sharma Richa Vashishtha Abhishek Sharma Sanjay Ranjan Deepak Gupta Vishnubhatla Sreenivas Sanjeev Sinha Ashutosh Biswas Vinay Gulati Clinical Characteristics of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome in North Indian Population of HIV/AIDS Patients Receiving HAART Clinical and Developmental Immunology |
| title | Clinical Characteristics of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome in North Indian Population of HIV/AIDS Patients Receiving HAART |
| title_full | Clinical Characteristics of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome in North Indian Population of HIV/AIDS Patients Receiving HAART |
| title_fullStr | Clinical Characteristics of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome in North Indian Population of HIV/AIDS Patients Receiving HAART |
| title_full_unstemmed | Clinical Characteristics of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome in North Indian Population of HIV/AIDS Patients Receiving HAART |
| title_short | Clinical Characteristics of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome in North Indian Population of HIV/AIDS Patients Receiving HAART |
| title_sort | clinical characteristics of tuberculosis associated immune reconstitution inflammatory syndrome in north indian population of hiv aids patients receiving haart |
| url | http://dx.doi.org/10.1155/2011/239021 |
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