BibTex format
@article{Bana:2016:10.1186/s12879-016-1850-2,
author = {Bana, TM and Lesosky, M and Pepper, DJ and van, der Plas H and Schutz, C and Goliath, R and Morroni, C and Mendelson, M and Maartens, G and Wilkinson, RJ and Meintjes, G},
doi = {10.1186/s12879-016-1850-2},
journal = {BMC Infectious Diseases},
title = {Prolonged tuberculosis-associated immune reconstitution inflammatory syndrome: characteristics and risk factors},
url = {http://dx.doi.org/10.1186/s12879-016-1850-2},
volume = {16},
year = {2016}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - BACKGROUND: In a proportion of patients with HIV-associated tuberculosis who develop paradoxical immune reconstitution inflammatory syndrome (IRIS), the clinical course of IRIS is prolonged necessitating substantial health care utilization for diagnostic and therapeutic interventions. Prolonged TB-IRIS has not been prospectively studied to date. We aimed to determine the proportion of patients with prolonged TB-IRIS, as well as the clinical characteristics and risk factors for prolonged TB-IRIS. METHODS: We pooled data from two prospective observational studies and a randomized controlled trial conducted in Cape Town, South Africa, that enrolled patients with paradoxical TB-IRIS. We used the same diagnostic approach and clinical case definitions for TB-IRIS in the 3 studies. Prolonged TB-IRIS was defined as TB-IRIS symptoms lasting > 90 days. Risk factors for prolonged TB-IRIS were analysed using Wilcoxon rank sum test, Fisher's exact test, multivariate logistic regression and Cox proportional hazards models. RESULTS: Two-hundred and sixteen patients with TB-IRIS were included. The median duration of TB-IRIS symptoms was 71.0 days (IQR 41.0-113.2). In 73/181 patients (40.3 %) with adequate follow-up data, IRIS duration was > 90 days. Six patients (3.3 %), mainly with lymph node involvement, had IRIS duration > 1 year. In univariate logistic regression analysis the following were significantly associated with IRIS duration > 90 days: lymph node involvement at initial TB diagnosis, drug-resistant TB, lymph node TB-IRIS, and not being hospitalised at time of TB-IRIS diagnosis. In our multivariate logistic regression model lymph node TB-IRIS (aOR 2.27, 95 % CI 1.13-4.59) and not being hospitalised at time of TB-IRIS diagnosis (aOR for being hospitalised 0.5, 95 % CI 0.25-0.99) remained significantly associated with prolonged TB-IRIS, and drug-resistant TB was of border
AU - Bana,TM
AU - Lesosky,M
AU - Pepper,DJ
AU - van,der Plas H
AU - Schutz,C
AU - Goliath,R
AU - Morroni,C
AU - Mendelson,M
AU - Maartens,G
AU - Wilkinson,RJ
AU - Meintjes,G
DO - 10.1186/s12879-016-1850-2
PY - 2016///
SN - 1471-2334
TI - Prolonged tuberculosis-associated immune reconstitution inflammatory syndrome: characteristics and risk factors
T2 - BMC Infectious Diseases
UR - http://dx.doi.org/10.1186/s12879-016-1850-2
VL - 16
ER -