Tuberculosis-associated immune reconstitution inflammatory syndrome: case definitions for use in resource-limited settings.
The immune reconstitution inflammatory syndrome (IRIS) has emerged as an important early complication of antiretroviral therapy (ART) in resource-limited settings, especially in patients with tuberculosis. However, there are no consensus case definitions for IRIS or tuberculosis-associated IRIS. Moreover, previously proposed case definitions are not readily applicable in settings where laboratory resources are limited. As a result, existing studies on tuberculosis-associated IRIS have used a variety of non-standardised general case definitions. To rectify this problem, around 100 researchers, including microbiologists, immunologists, clinicians, epidemiologists, clinical trialists, and public-health specialists from 16 countries met in Kampala, Uganda, in November, 2006. At this meeting, consensus case definitions for paradoxical tuberculosis-associated IRIS, ART-associated tuberculosis, and unmasking tuberculosis-associated IRIS were derived, which can be used in high-income and resource-limited settings. It is envisaged that these definitions could be used by clinicians and researchers in a variety of settings to promote standardisation and comparability of data.
Meintjes
Graeme
G
Institute of Infectious Diseases and Molecular Medicine and Department of Medicine, University of Cape Town, Cape Town, South Africa.
Lawn
Stephen D
SD
Scano
Fabio
F
Maartens
Gary
G
French
Martyn A
MA
Worodria
William
W
Elliott
Julian H
JH
Murdoch
David
D
Wilkinson
Robert J
RJ
Seyler
Catherine
C
John
Laurence
L
van der Loeff
Maarten Schim
MS
Reiss
Peter
P
Lynen
Lut
L
Janoff
Edward N
EN
Gilks
Charles
C
Colebunders
Robert
R
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006295:Health Resources; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000175:diagnosis* / Q000276:immunology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011203:Poverty; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology*
D019380:Anti-HIV Agents; D000995:Antitubercular Agents