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Clinical and Developmental Immunology
Volume 2011 (2011), Article ID 239021, 9 pages
http://dx.doi.org/10.1155/2011/239021
Clinical Study

Clinical Characteristics of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome in North Indian Population of HIV/AIDS Patients Receiving HAART

1Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
2Division of Pulmonary, Critical Care, & Sleep Medicine, Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
3University of Medicine, Pleven, Bulgaria
4Department of Biostatistics, All India Institute of Medical Sciences, New Delhi 110029, India

Received 14 July 2010; Revised 9 September 2010; Accepted 31 October 2010

Academic Editor: Katalin Andrea Wilkinson

Copyright © 2011 Suman Karmakar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background & Objective. IRIS is an important complication that occurs during management of HIV-TB coinfection and it poses difficulty in diagnosis. Previous studies have reported variable incidence of IRIS. The present study was undertaken to describe the pattern of TB-associated IRIS using recently proposed consensus case-definitions for TB-IRIS for its use in resource-limited settings. Methods. A prospective analysis of ART-naïve adults started on HAART from November, 2008 to May, 2010 was done in a tertiary care hospital in north India. A total 224 patients divided into two groups, one with HIV-TB and the other with HIV alone, were followedup for a minimum period of 3 months. The diagnosis of TB was categorised as ‘‘definitive’’ and ‘‘probable’’. Results. Out of a total of 224 patients, 203 completed followup. Paradoxical TB-IRIS occurred in 5 of 123 (4%) HIV-TB patients while 6 of 80 (7.5%) HIV patients developed ART-associated TB. A reduction in plasma viral load was significantly ( ) associated with paradoxical TB-IRIS. No identifiable risk factors were associated with the development of ART-associated TB. Conclusion. The consensus case-definitions are useful tools in the diagnosis of TB-associated IRIS. High index of clinical suspicion is required for an early diagnosis.