Author | Narendran, Gopalan | |
Author | Jyotheeswaran, Keerthana | |
Author | Senguttuvan, Thirumaran | |
Author | Vinhaes, Caian L. | |
Author | Santhanakrishnan, Ramesh K. | |
Author | Manoharan, Tamizhselvan | |
Author | Selvaraj, Anbhalagan | |
Author | Chandrasekaran, Padmapriyadarsini | |
Author | Menon, Pradeep A. | |
Author | Bhavani, Kannabiran P. | |
Author | Reddy, Devarajulu | |
Author | Narayanan, Ravichandran | |
Author | Subramanyam, Balaji | |
Author | Sathyavelu, Sekhar | |
Author | Krishnaraja, Raja | |
Author | Kalirajan, Pownraj | |
Author | Angamuthu, Dhanalakshmi | |
Author | Susaimuthu, Stella Mary | |
Author | Ganesan, Ranjit R. K. | |
Author | Tripathy, Srikanth P. | |
Author | Swaminathan, Soumya | |
Author | Andrade, Bruno de Bezerril | |
Access date | 2020-08-13T11:44:02Z | |
Available date | 2020-08-13T11:44:02Z | |
Document date | 2020 | |
Citation | NARENDRAN, Gopalan et al. Characteristics of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome and its influence on tuberculosis treatment outcomes in persons living with HIV. International Journal of Infectious Diseases, v. 98, p. 261–267, 2020. | pt_BR |
ISSN | 1201-9712 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/42740 | |
Description | Caian L Vinhaes e Bruno B Andrade - Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brazil. | pt_BR |
Description | a National Institute for Research in Tuberculosis, Indian Council of Medical Research Chennai, Tamil Nadu, India
b Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
c Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil
d Curso de Medicina, Faculdade de Tecnologia e Ciências (UniFTC), Salvador, Brazil
e Government Hospital of Thoracic Medicine, Tambaram Sanatorium, Chennai, Tamil Nadu, India
f Rajiv Gandhi Government General Hospital, Park Town, Chennai, Tamil Nadu, India
g Government Rajaji Hospital, Madurai, Tamil Nadu, India
hWorld Health Organization, Geneva, Switzerland
i Universidade Salvador (UNIFACS), Laureate Universities, Salvador, Brazil
j Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
kWellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town,
South Africa | |
Sponsorship | Irini Sereti
(National Institutes of Health [NIH], USA), Brian Porter (NIH),
Alan Sher (NIH), Lis Antonelli (Fundação Oswaldo Cruz, Brazil),
Cynthia Lassnoff (NIH), Christopher Whalen (NIH), Michael
Duvenhage (NIH) and Drs Thomas Nutman, Subash Babu and
Aleyamma Thomas from NIH who provided valuable input and
periodical guidance. We deeply appreciate the work of the team
members at the National Institute of Research in Tuberculosis
(NIRT), India: Lokeshwaran Nithyananthan, Solomon Priyaku-
mar, Rajasekaran Subramani and Ramesh Babu, for clinical
procedures; Syed Hissar, Kannan, Murugesan, Sudha Subrama-
nium, Luke Elizabeth Hanna for lab support. We also thank the
entire team of medical officers and nursing staff of NIRT-
Chennai, NIRT-Madurai and the Government Hospital of
Thoracic Medicine. We
finally acknowledge the excellent
secretarial assistance given by Sanathanakumar Natarajan and
Maheshwari Theyagarajan (NIRT). This retrospective study did not receive specific funding. The work from BBA was supported
by the Intramural Research programme of the Fundação
Oswaldo Cruz (FIOCRUZ), and the Conselho Nacional de
Desenvolvimento Científico e Tecnológico (CNPq; senior scientist
fellowship). CLV received fellowship from CNPq. The funders
had no role in study design, data collection and analysis,
decision to publish, or preparation of the manuscript. | pt_BR |
Language | eng | pt_BR |
Publisher | Elsevier | pt_BR |
Rights | open access | pt_BR |
Subject in Portuguese | HIV | pt_BR |
Subject in Portuguese | Tuberculose | pt_BR |
Subject in Portuguese | Terapia anti-retroviral | pt_BR |
Subject in Portuguese | Tratamento anti-TB | pt_BR |
Subject in Portuguese | ÍRIS | pt_BR |
Subject in Portuguese | Reação paradoxal | pt_BR |
Title | Characteristics of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome and its influence on tuberculosis treatment outcomes in persons living with HIV | pt_BR |
Type | Article | pt_BR |
DOI | 10.1016/j.ijid.2020.06.097 | |
Abstract | Objective: The influence of tuberculosis (TB)-immune reconstitution inflammatory syndrome (IRIS) on TB treatment outcomes and its risk factors were investigated among people with human immunodeficiency virus (HIV) and co-infected with TB. Methods: Newly diagnosed, culture-confirmed, pulmonary TB patients with HIV and enrolled in a clinical trial (NCT00933790) were retrospectively analysed for IRIS occurrence. Risk factors and TB outcomes (up to 18 months after initiation of anti-TB treatment [ATT]) were compared between people who experienced IRIS (IRIS group) and those who did not (non-IRIS group). Results: TB-IRIS occurred in 82 of 292 (28%) participants. Significant baseline risk factors predisposing to TB-IRIS occurrence in univariate analysis were: lower CD4+ T-cell count, CD4/CD8 ratio, haemoglobin levels, presence of extra-pulmonary TB focus, and higher HIV viral load; the last two retained significance in the multivariate analysis. After 2 months of ATT commencement, sputum smear conversion was documented in 45 of 80 (56.2%) vs. 124 of 194 (63.9%) (p=0.23), culture conversion was in 75 of 80 (93.7%) vs. 178 of 194 (91.7%) (p=0.57) and the median decline in viral load (log10copies/mm3) was 2.7 in the IRIS vs. 1.1 in the non-IRIS groups (p<0.0001), respectively. An unfavourable response to TB therapy was detected in 17 of 82 (20.7%) and 28 of 210 (13.3%) in the IRIS and non-IRIS groups, respectively (p=0.14). Conclusions: TB-IRIS frequently occurred in people with advanced HIV infection and in those who presented with extra-pulmonary TB lesions, without influencing subsequent TB treatment outcomes. | pt_BR |
Affilliation | Múltipla – Ver em notas. | pt_BR |
Subject | HIV | pt_BR |
Subject | Tuberculosis | pt_BR |
Subject | Antiretroviral therapy | pt_BR |
Subject | Anti-TB treatment | pt_BR |
Subject | IRIS | pt_BR |
Subject | Paradoxical reaction | pt_BR |