Incidence of immune reconstitution syndrome in HIV/tuberculosis-coinfected patients after initiation of generic antiretroviral therapy in India
Incidence of immune reconstitution syndrome in HIV/tuberculosis-coinfected patients after initiation of generic antiretroviral therapy in India
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DOI：
10.1097/00126334-200412150-00007
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发表时间：
2004-12-15
影响因子：
3.6
通讯作者：
Flanigan, TP
中科院分区：
文献类型：
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作者：
Kumarasamy, N;Chaguturu, S;Flanigan, TP
本文介绍了免疫重建综合征（IRS）的发病率从发展中国家和临床医生的影响。144例HIV和结核病（TB）合并感染者中有11例在开始通用高效抗逆转录病毒治疗（HAART）后6个月内发生IRS，随访时间为72人年。所有IRS患者均为男性，中位年龄为29岁; HAART启动时的中位CD 4为123个细胞/mm（3），6个月时的中位CD 4升高为124个细胞/mm（3）。在HAART开始时，发生IRS的患者与未发生IRS的患者之间在CD 4升高或CD 4计数以及TB治疗持续时间方面无统计学差异（P=0.8380）。出现临床IRS的中位时间为42天（范围10-89天）。该队列中IRS的发生率为15.2例/100患者-年。随着机会性感染，特别是结核病的共患病率增加，以及发展中国家获得抗逆转录病毒治疗的机会增加，这些国家的临床医生必须能够识别IRS并在不影响临床护理的情况下缓解症状。
This paper describes the incidence of immune reconstitution syndrome (IRS) from the developing world and implications for clinicians. Eleven of 144 HIV and tuberculosis (TB)-coinfected individuals followed for 72 person-years developed IRS within 6 months of initiating generic highly active antiretroviral therapy (HAART). All of the IRS patients were male, with a median age of 29 years; median CD4 at HAART initiation was 123 cells/mm(3), and 6-month median CD4 rise was 124 cells/mm(3). There was no statistical difference in CD4 rise or CD4 count and duration of TB treatment at HAART initiation between those who did and those who did not develop IRS (P=0.8380). The median time to development of clinical IRS was 42 days (range 10-89 days). The incidence of IRS in this cohort is 15.2 cases per 100 patient-years. With increased coprevalence of opportunistic infections, especially TB, and increasing access to antiretroviral therapy in the developing world, clinicians in these countries must be able to identify IRS and relieve symptoms without compromising clinical care.