Antiretroviral Treatment-Associated Tuberculosis in a Prospective Cohort of HIV-Infected Patients Starting ART
Table 1
The International Network for the Study of HIV-Associated IRIS (INSHI) case definition for ART-associated tuberculosis [22].
ART-associated tuberculosis
(i) Patient is not receiving treatment for tuberculosis when ART is initiated.
(ii) Active tuberculosis is diagnosed after initiation of ART.
(iii) The diagnosis of tuberculosis should fulfil WHO criteria for smear-positive pulmonary tuberculosis, smear-negative pulmonary tuberculosis, or extrapulmonary tuberculosis.
Unmasking tuberculosis-associated IRIS*
(i) Patient is not receiving treatment for tuberculosis when ART is initiated and then presents with tuberculosis within 3 months of starting ART.
And one of the following criteria must be met:
(ii) heightened intensity of clinical manifestations, particularly if there is evidence of a marked inflammatory component to the presentation. Examples include tuberculosis lymphadenitis or tuberculosis abscesses with prominent acute inflammatory features, presentation with tuberculosis that is complicated by respiratory failure due to adult respiratory distress syndrome, and those who present with a marked systemic inflammatory syndrome related to tuberculosis,
(iii) once established on tuberculosis treatment, a clinical course that is complicated by a paradoxical reaction.
