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See 1 citation in 2015 by Namale PE:

Future Microbiol. 2015;10(6):1077-99. doi: 10.2217/fmb.15.9.

Paradoxical TB-IRIS in HIV-infected adults: a systematic review and meta-analysis.

Author information

1
Department of Medicine, University of Cape Town, Cape Town, South Africa.
2
Vaccines for Africa Initiative, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa.
3
Department of Medicine, New Somerset Hospital, Cnr Beach & Lower Portswood Road, Green Point, Cape Town 8001, Western Cape, South Africa.
4
Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
5
Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease & Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa.
6
Department of Medicine, Imperial College London, W2 1PG, UK.
7
Medical Research Council, National Institute of Medical Research, London, NW7 1AA, UK.

Abstract

Paradoxical tuberculosis immune reconstitution inflammatory syndrome (TB-IRIS) was first described almost two decades ago. We undertook this systematic review and meta-analysis to collate findings across studies that have reported the incidence, clinical features, management and outcomes of paradoxical TB-IRIS. Forty studies that cumulatively reported 1048 paradoxical TB-IRIS cases were included. The pooled estimated incidence among patients with HIV-associated TB initiating antiretroviral therapy was 18% (95% CI: 16-21%). Frequent features were pulmonary and lymph node involvement. Hospitalization occurred in 25% (95% CI: 19-30%). In studies that reported treatment, corticosteroids were prescribed more frequently (38%; 95% CI: 27-48%) than nonsteroidal anti-inflammatory drugs (28%; 95% CI: 2-53%). Case fatality was 7% (95% CI: 4-11%), but death attributed to TB-IRIS occurred in 2% of cases (95% CI: 1-3%).

KEYWORDS:

HIV; IRIS; antiretroviral therapy; immune reconstitution inflammatory syndrome; paradoxical; tuberculosis

PMID:
26059627
DOI:
10.2217/fmb.15.9
[Indexed for MEDLINE]
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