| Literature DB >> 26059627 |
Phiona E Namale1, Leila H Abdullahi2, Stacey Fine3, Monika Kamkuemah4, Robert J Wilkinson1,5,6,7, Graeme Meintjes1,5,6.
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%).Entities:
Keywords: HIV; IRIS; antiretroviral therapy; immune reconstitution inflammatory syndrome; paradoxical; tuberculosis
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Year: 2015 PMID： 26059627 DOI： 10.2217/fmb.15.9
Source DB: PubMed Journal: Future Microbiol ISSN： 1746-0913 Impact factor: 3.165