Autor | Coelho, Lara E. | |
Autor | Chazallon, Corine | |
Autor | Laureillard, Didier | |
Autor | Escada, Rodrigo | |
Autor | N'takpe, Jean-Baptiste | |
Autor | Timana, Isabelle | |
Autor | Messou, Eugène | |
Autor | Eholie, Serge | |
Autor | Khosa, Celso | |
Autor | Chau, Giang D. | |
Autor | Cardoso, Sandra Wagner | |
Autor | Veloso, Valdiléa G. | |
Autor | Delaugerre, Constance | |
Autor | Molina, Jean-Michel | |
Autor | Grinsztejn, Beatriz | |
Autor | Marcy, Olivier | |
Autor | Castro, Nathalie De | |
Data de acesso | 2024-04-25T23:21:36Z | |
Data de disponibilização | 2024-04-25T23:21:36Z | |
Data do publicação | 2024 | |
Citação | COELHO, Lara E. et al. Incidence and Predictors of Tuberculosis-associated IRIS in People With HIV Treated for Tuberculosis: Findings From Reflate TB2 Randomized Trial. Open Forum Infectious Diseases, v. 11, n. 3, p. 1-9, Jan. 2024. | en_US |
ISSN | 2328-8957 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/63700 | |
Idioma | eng | en_US |
Editor | Oxford University Press on behalf of the Infectious Diseases Society of America | en_US |
Direito Autoral | open access | en_US |
Título | Incidence and Predictors of Tuberculosis-associated IRIS in People With HIV Treated for Tuberculosis: Findings From Reflate TB2 Randomized Trial | en_US |
Tipo do documento | Article | en_US |
DOI | 10.1093/ofid/ofae035 | |
Resumo em Inglês | Background: After antiretroviral therapy (ART) initiation, people with HIV (PWH) treated for tuberculosis (TB) may develop TB-associated immune reconstitution inflammatory syndrome (TB-IRIS). Integrase inhibitors, by providing a faster HIV-RNA decline than efavirenz, might increase the risk for this complication. We sought to assess incidence and determinants of TB-IRIS in PWH with TB on raltegravir- or efavirenz-based ART. Methods: We conducted a secondary analysis of the Reflate TB 2 trial, which randomized ART-naive PWH on standard TB treatment, to receive raltegravir- or efavirenz-based ART. The primary objective was to evaluate the incidence of TB-IRIS. Incidence rate ratio comparing TB-IRIS incidence in each arm was calculated. Kaplan-Meier curves were used to compare TB-IRIS-free survival probabilities by ART arm. Cox regression models were fitted to analyze baseline characteristics associated with TB-IRIS. Results: Of 460 trial participants, 453 from Brazil, Côte d'Ivoire, Mozambique, and Vietnam were included in this analysis. Baseline characteristics were median age 35 years (interquartile range [IQR], 29-43), 40% female, 69% pulmonary TB only, median CD4, 102 (IQR, 38-239) cells/mm³, and median HIV RNA, 5.5 (IQR, 5.0-5.8) log copies/mL. Forty-eight participants developed TB-IRIS (incidence rate, 24.7/100 PY), 19 cases in the raltegravir arm and 29 in the efavirenz arm (incidence rate ratio 0.62, 95% confidence interval .35-1.10). Factors associated with TB-IRIS were: CD4 ≤ 100 cells/μL, HIV RNA ≥500 000 copies/mL, and extrapulmonary/disseminated TB. Conclusions: We did not demonstrate that raltegravir-based ART increased the incidence of TB-IRIS compared with efavirenz-based ART. Low CD4 counts, high HIV RNA, and extrapulmonary/disseminated TB at ART initiation were associated with TB-IRIS. | en_US |
Afiliação | Oswaldo Cruz Foundation. National Institute of Infectious Diseases Evandro Chagas. STD and AIDS Clinical Research Laboratory. Rio de Janeiro, RJ, Brazil. | en_US |
Afiliação | National Institute for Health and Medical Research. Research Institute for Sustainable Development. Bordeaux Population Health Centre. University of Bordeaux. Bordeaux, France. | en_US |
Afiliação | Nimes University Hospital. Department of Infectious and Tropical Diseases. Nimes, France / Research Unit 1058. Pathogenesis and Control Chronical Infections. INSERM. French Blood Center. University of Montpellier. Montpellier, France. | en_US |
Afiliação | Oswaldo Cruz Foundation. National Institute of Infectious Diseases Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Afiliação | National Institute for Health and Medical Research. Research Institute for Sustainable Development. Bordeaux Population Health Centre. University of Bordeaux. Bordeaux, France / Programme PACCI/ANRS Research Center. Abidjan, Côte-d'Ivoire. | en_US |
Afiliação | Instituto Nacional de Saúde. Marracuene, Mozambique. | en_US |
Afiliação | Programme PACCI/ANRS Research Center. Abidjan, Côte-d'Ivoire / Centre de Prise en Charge de Recherche et de Formation. CePReF-Aconda-VS. Abidjan, Cote D'Ivoire / Université Félix Houphouët Boigny. UFR des Sciences Médicales. Département de Dermatologie et d'Infectiologie. Abidjan, Cote d'Ivoire. | en_US |
Afiliação | Programme PACCI/ANRS Research Center. Abidjan, Côte-d'Ivoire / Université Félix Houphouët Boigny. UFR des Sciences Médicales. Département de Dermatologie et d'Infectiologie. Abidjan, Cote d'Ivoire. | en_US |
Afiliação | Instituto Nacional de Saúde. Marracuene, Mozambique. | en_US |
Afiliação | Pham Ngoc Thach Hospital. Ho Chi Minh City, Vietnam. | en_US |
Afiliação | Oswaldo Cruz Foundation. National Institute of Infectious Diseases Evandro Chagas. STD and AIDS Clinical Research Laboratory. Rio de Janeiro, RJ, Brazil. | en_US |
Afiliação | Oswaldo Cruz Foundation. National Institute of Infectious Diseases Evandro Chagas. STD and AIDS Clinical Research Laboratory. Rio de Janeiro, RJ, Brazil. | en_US |
Afiliação | APHP-Hôpital Saint-Louis. Virology Department. Paris, France / INSERM U944. Paris, France / Université Paris Cité. Paris, France. | en_US |
Afiliação | INSERM U944. Paris, France / Université Paris Cité. Paris, France / AP-HP-Hôpital Saint-Louis Lariboisière. Infectious Diseases Department. Paris, France. | en_US |
Afiliação | Oswaldo Cruz Foundation. National Institute of Infectious Diseases Evandro Chagas. STD and AIDS Clinical Research Laboratory. Rio de Janeiro, RJ, Brazil. | en_US |
Afiliação | National Institute for Health and Medical Research. Research Institute for Sustainable Development. Bordeaux Population Health Centre. University of Bordeaux. Bordeaux, France. | en_US |
Afiliação | National Institute for Health and Medical Research. Research Institute for Sustainable Development. Bordeaux Population Health Centre. University of Bordeaux. Bordeaux, France / AP-HP-Hôpital Saint-Louis Lariboisière. Infectious Diseases Department. Paris, France. | en_US |
Palavras-chave em inglês | Antiretroviral therapy | en_US |
Palavras-chave em inglês | HIV/AIDS | en_US |
Palavras-chave em inglês | IRIS | en_US |
Palavras-chave em inglês | Randomized controlled trial | en_US |
Palavras-chave em inglês | Tuberculosis | en_US |
e-ISSN | 2328-8957 | |