Incidence and risk factors of immune reconstitution inflammatory syndrome in HIV-TB coinfected patients

Detalhes bibliográficos
Autor(a) principal: Dibyendu,De
Data de Publicação: 2011
Outros Autores: Sarkar,Rathindra Nath, Phaujdar,Sibaji, Bhattacharyya,Kuntal, Pal,Hare Krishna
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Brazilian Journal of Infectious Diseases
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702011000600009
Resumo: Tuberculosis is one of the leading causes of development of Immune reconstitution inflammatory syndrome (IRIS) in HIV patients receiving antiretroviral therapy (ART). OBJECTIVE: To determine the incidence of IRIS in HIV-TB coinfected patients, and to find out the possible risk factors associated with IRIS. MATERIALS AND METHODS: Study commenced with 96 patients adhered to standard antitubercular therapy (ATT) and ART without defaultering, and followed up for six months. RESULT: The mean (± SD) CD4 count and CD4 percentage at baseline was 59.16 (± 24.63) per mm³ and 4.59% (± 1.73) respectively. Only 18.75% developed IRIS after 57.05 (± 14.12) days of initiation of ART. Extrapulmonary tuberculosis was the most significant factor associated with IRIS (83.33%) than those without IRIS (44.87%) (p = 0.0032). Specifically, tubercular lymphadenitis (38.88%, p = 0.0364) and disseminated tuberculosis (33.33%, p = 0.0217) were significantly associated with IRIS. The other risk factors associated with appearance of IRIS were higher CD4 count (p = 0.0212) at three months after initiation of ART and increment of CD4 count (p = 0.0063) and CD4 percentage (p = 0.0016) during this period. The major manifestations of IRIS were fever (40%), followed by lymphadenitis (38%). The mortality rate in IRIS was not higher than those without IRIS. CONCLUSION: Patients with extrapulmonary tuberculosis, especially tubercular lymphadenitis, were more likely to develop IRIS and fever was associated in most of them. Higher increment of CD4 count may indicate development of IRIS in presence of new or worsening tuberculosis lesion.
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spelling Incidence and risk factors of immune reconstitution inflammatory syndrome in HIV-TB coinfected patientsHIVtuberculosisimmune reconstitution inflammatory syndromeCD4 lymphocyte countTuberculosis is one of the leading causes of development of Immune reconstitution inflammatory syndrome (IRIS) in HIV patients receiving antiretroviral therapy (ART). OBJECTIVE: To determine the incidence of IRIS in HIV-TB coinfected patients, and to find out the possible risk factors associated with IRIS. MATERIALS AND METHODS: Study commenced with 96 patients adhered to standard antitubercular therapy (ATT) and ART without defaultering, and followed up for six months. RESULT: The mean (± SD) CD4 count and CD4 percentage at baseline was 59.16 (± 24.63) per mm³ and 4.59% (± 1.73) respectively. Only 18.75% developed IRIS after 57.05 (± 14.12) days of initiation of ART. Extrapulmonary tuberculosis was the most significant factor associated with IRIS (83.33%) than those without IRIS (44.87%) (p = 0.0032). Specifically, tubercular lymphadenitis (38.88%, p = 0.0364) and disseminated tuberculosis (33.33%, p = 0.0217) were significantly associated with IRIS. The other risk factors associated with appearance of IRIS were higher CD4 count (p = 0.0212) at three months after initiation of ART and increment of CD4 count (p = 0.0063) and CD4 percentage (p = 0.0016) during this period. The major manifestations of IRIS were fever (40%), followed by lymphadenitis (38%). The mortality rate in IRIS was not higher than those without IRIS. CONCLUSION: Patients with extrapulmonary tuberculosis, especially tubercular lymphadenitis, were more likely to develop IRIS and fever was associated in most of them. Higher increment of CD4 count may indicate development of IRIS in presence of new or worsening tuberculosis lesion.Brazilian Society of Infectious Diseases2011-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702011000600009Brazilian Journal of Infectious Diseases v.15 n.6 2011reponame:Brazilian Journal of Infectious Diseasesinstname:Brazilian Society of Infectious Diseases (BSID)instacron:BSID10.1590/S1413-86702011000600009info:eu-repo/semantics/openAccessDibyendu,DeSarkar,Rathindra NathPhaujdar,SibajiBhattacharyya,KuntalPal,Hare Krishnaeng2012-01-04T00:00:00Zoai:scielo:S1413-86702011000600009Revistahttps://www.bjid.org.br/https://old.scielo.br/oai/scielo-oai.phpbjid@bjid.org.br||lgoldani@ufrgs.br1678-43911413-8670opendoar:2012-01-04T00:00Brazilian Journal of Infectious Diseases - Brazilian Society of Infectious Diseases (BSID)false
dc.title.none.fl_str_mv Incidence and risk factors of immune reconstitution inflammatory syndrome in HIV-TB coinfected patients
title Incidence and risk factors of immune reconstitution inflammatory syndrome in HIV-TB coinfected patients
spellingShingle Incidence and risk factors of immune reconstitution inflammatory syndrome in HIV-TB coinfected patients
Dibyendu,De
HIV
tuberculosis
immune reconstitution inflammatory syndrome
CD4 lymphocyte count
title_short Incidence and risk factors of immune reconstitution inflammatory syndrome in HIV-TB coinfected patients
title_full Incidence and risk factors of immune reconstitution inflammatory syndrome in HIV-TB coinfected patients
title_fullStr Incidence and risk factors of immune reconstitution inflammatory syndrome in HIV-TB coinfected patients
title_full_unstemmed Incidence and risk factors of immune reconstitution inflammatory syndrome in HIV-TB coinfected patients
title_sort Incidence and risk factors of immune reconstitution inflammatory syndrome in HIV-TB coinfected patients
author Dibyendu,De
author_facet Dibyendu,De
Sarkar,Rathindra Nath
Phaujdar,Sibaji
Bhattacharyya,Kuntal
Pal,Hare Krishna
author_role author
author2 Sarkar,Rathindra Nath
Phaujdar,Sibaji
Bhattacharyya,Kuntal
Pal,Hare Krishna
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Dibyendu,De
Sarkar,Rathindra Nath
Phaujdar,Sibaji
Bhattacharyya,Kuntal
Pal,Hare Krishna
dc.subject.por.fl_str_mv HIV
tuberculosis
immune reconstitution inflammatory syndrome
CD4 lymphocyte count
topic HIV
tuberculosis
immune reconstitution inflammatory syndrome
CD4 lymphocyte count
description Tuberculosis is one of the leading causes of development of Immune reconstitution inflammatory syndrome (IRIS) in HIV patients receiving antiretroviral therapy (ART). OBJECTIVE: To determine the incidence of IRIS in HIV-TB coinfected patients, and to find out the possible risk factors associated with IRIS. MATERIALS AND METHODS: Study commenced with 96 patients adhered to standard antitubercular therapy (ATT) and ART without defaultering, and followed up for six months. RESULT: The mean (± SD) CD4 count and CD4 percentage at baseline was 59.16 (± 24.63) per mm³ and 4.59% (± 1.73) respectively. Only 18.75% developed IRIS after 57.05 (± 14.12) days of initiation of ART. Extrapulmonary tuberculosis was the most significant factor associated with IRIS (83.33%) than those without IRIS (44.87%) (p = 0.0032). Specifically, tubercular lymphadenitis (38.88%, p = 0.0364) and disseminated tuberculosis (33.33%, p = 0.0217) were significantly associated with IRIS. The other risk factors associated with appearance of IRIS were higher CD4 count (p = 0.0212) at three months after initiation of ART and increment of CD4 count (p = 0.0063) and CD4 percentage (p = 0.0016) during this period. The major manifestations of IRIS were fever (40%), followed by lymphadenitis (38%). The mortality rate in IRIS was not higher than those without IRIS. CONCLUSION: Patients with extrapulmonary tuberculosis, especially tubercular lymphadenitis, were more likely to develop IRIS and fever was associated in most of them. Higher increment of CD4 count may indicate development of IRIS in presence of new or worsening tuberculosis lesion.
publishDate 2011
dc.date.none.fl_str_mv 2011-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702011000600009
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702011000600009
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S1413-86702011000600009
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Brazilian Society of Infectious Diseases
publisher.none.fl_str_mv Brazilian Society of Infectious Diseases
dc.source.none.fl_str_mv Brazilian Journal of Infectious Diseases v.15 n.6 2011
reponame:Brazilian Journal of Infectious Diseases
instname:Brazilian Society of Infectious Diseases (BSID)
instacron:BSID
instname_str Brazilian Society of Infectious Diseases (BSID)
instacron_str BSID
institution BSID
reponame_str Brazilian Journal of Infectious Diseases
collection Brazilian Journal of Infectious Diseases
repository.name.fl_str_mv Brazilian Journal of Infectious Diseases - Brazilian Society of Infectious Diseases (BSID)
repository.mail.fl_str_mv bjid@bjid.org.br||lgoldani@ufrgs.br
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