title: Clinical characteristics of tuberculosis-associated immune reconstitution inflammatory syndrome in North Indian population of HIV/AIDS patients receiving HAART.
abstract: 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 (P = .016) associated with paradoxical TB-IRIS. No identifiable risk factors were associated with the development of ART-associated TB.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Suman
authors.initials: S
authors.lastname: Karmakar
authors.forename: Surendra K
authors.initials: SK
authors.lastname: Sharma
authors.forename: Richa
authors.initials: R
authors.lastname: Vashishtha
authors.forename: Abhishek
authors.initials: A
authors.lastname: Sharma
authors.forename: Sanjay
authors.initials: S
authors.lastname: Ranjan
authors.forename: Deepak
authors.initials: D
authors.lastname: Gupta
authors.forename: Vishnubhatla
authors.initials: V
authors.lastname: Sreenivas
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sinha
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Biswas
authors.forename: Vinay
authors.initials: V
authors.lastname: Gulati
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D000995:Antitubercular Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D005260:Female; D006678:HIV; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D007194:India; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D000995:Antitubercular Agents; D015415:Biomarkers