title: Tuberculosis-associated immune reconstitution inflammatory syndrome: case definitions for use in resource-limited settings.
abstract: 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.
authors.affiliation: Institute of Infectious Diseases and Molecular Medicine and Department of Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Graeme
authors.initials: G
authors.lastname: Meintjes
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Lawn
authors.forename: Fabio
authors.initials: F
authors.lastname: Scano
authors.forename: Gary
authors.initials: G
authors.lastname: Maartens
authors.forename: Martyn A
authors.initials: MA
authors.lastname: French
authors.forename: William
authors.initials: W
authors.lastname: Worodria
authors.forename: Julian H
authors.initials: JH
authors.lastname: Elliott
authors.forename: David
authors.initials: D
authors.lastname: Murdoch
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Wilkinson
authors.forename: Catherine
authors.initials: C
authors.lastname: Seyler
authors.forename: Laurence
authors.initials: L
authors.lastname: John
authors.forename: Maarten Schim
authors.initials: MS
authors.lastname: van der Loeff
authors.forename: Peter
authors.initials: P
authors.lastname: Reiss
authors.forename: Lut
authors.initials: L
authors.lastname: Lynen
authors.forename: Edward N
authors.initials: EN
authors.lastname: Janoff
authors.forename: Charles
authors.initials: C
authors.lastname: Gilks
authors.forename: Robert
authors.initials: R
authors.lastname: Colebunders
mesh_terms: 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*
chemical_list: D019380:Anti-HIV Agents; D000995:Antitubercular Agents