@article{Narendran2020,
abstract = {OBJECTIVE: Tuberculosis (TB)-associated immune reconstitution inflammatory Syndrome (IRIS) influence on TB treatment outcomes and its risk factors were investigated among persons with HIV coinfected with TB. METHODS: Newly diagnosed, culture-confirmed, pulmonary TB patients with HIV, enrolled in a clinical trial (NCT00933790) were retrospectively analyzed for IRIS occurrence. Risk factors and TB outcomes (for up to 18 months after initiation of anti-TB treatment [ATT]) were compared between patients experiencing IRIS (IRIS group) and those who did not (Non-IRIS group). RESULTS: TB-IRIS occurred in 28{\%} (82/292) of patients. Significant baseline risk factors predisposing to TB-IRIS occurrence in univariate analysis were lower CD4(+) T-cell count, CD4/CD8 ratio, hemoglobin levels, as well as presence of extra-pulmonary TB focus and higher HIV viral load, with the last two retaining significance in the multivariate analysis. After 2 months of ATT commencement, sputum smear conversion was documented in 45/80 (56.2{\%}) vs. 124/194 (63.9{\%}) (p = 0.23), culture conversion was 75/80 (93.7{\%}) vs. 178/194 (91.7{\%}) (p = 0.57) and the median decline in viral load (log(10)copies/mm(3)) being 2.7 in the IRIS vs. 1.1 in the non-IRIS groups (p {\textless} 0.0001), respectively. The unfavourable response to TB therapy was detected in 17/82 (20.7{\%}) and 28/210 (13.3{\%}) in the IRIS and non-IRIS groups, respectively (p = 0.14). CONCLUSIONS: TB-IRIS occurs frequently in persons with advanced HIV infection and in those presenting with extra-pulmonary TB lesions, without influencing subsequent TB treatment outcomes.},
author = {Narendran, Gopalan and Jyotheeswaran, Keerthana and Senguttuvan, Thirumaran and Vinhaes, Caian and Santhanakrishnan, Ramesh and Manoharan, Tamizhselvan and Selvaraj, Anbhalagan and Chandrasekaran, Padmapriyadarsini and Menon, Pradeep and Bhavani, Kannabiran and Reddy, Devarajulu and Narayanan, Ravichandran and Subramanyam, Balaji and Sathyavelu, Sekhar and Krishnaraja, Raja and Kalirajan, Pownraj and Angamuthu, Dhanalakshmi and Susaimuthu, Stella Mary and Ganesan, Ranjit and Tripathy, Srikanth and Swaminathan, Soumya and Andrade, Bruno B},
doi = {10.1016/j.ijid.2020.06.097},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Narendran et al. - 2020 - Characteristics of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome and its inf.pdf:pdf},
issn = {1201-9712},
journal = {International Journal of Infectious Diseases},
keywords = {HIV,IRIS,OA,anti-TB treatment,antiretroviral therapy,fund{\_}not{\_}ack,original,paradoxical reaction,tuberculosis},
mendeley-tags = {OA,fund{\_}not{\_}ack,original},
month = {sep},
pages = {261--267},
pmid = {32623087},
publisher = {Elsevier},
title = {{Characteristics of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome and its influence on tuberculosis treatment outcomes in persons living with HIV}},
url = {https://doi.org/10.1016/j.ijid.2020.06.097},
volume = {98},
year = {2020}
}

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METHODS: Newly diagnosed, culture-confirmed, pulmonary TB patients with HIV, enrolled in a clinical trial (NCT00933790) were retrospectively analyzed for IRIS occurrence. Risk factors and TB outcomes (for up to 18 months after initiation of anti-TB treatment [ATT]) were compared between patients experiencing IRIS (IRIS group) and those who did not (Non-IRIS group). RESULTS: TB-IRIS occurred in 28% (82/292) of patients. Significant baseline risk factors predisposing to TB-IRIS occurrence in univariate analysis were lower CD4(+) T-cell count, CD4/CD8 ratio, hemoglobin levels, as well as presence of extra-pulmonary TB focus and higher HIV viral load, with the last two retaining significance in the multivariate analysis. After 2 months of ATT commencement, sputum smear conversion was documented in 45/80 (56.2%) vs. 124/194 (63.9%) (p = 0.23), culture conversion was 75/80 (93.7%) vs. 178/194 (91.7%) (p = 0.57) and the median decline in viral load (log(10)copies/mm(3)) being 2.7 in the IRIS vs. 1.1 in the non-IRIS groups (p \\textless 0.0001), respectively. The unfavourable response to TB therapy was detected in 17/82 (20.7%) and 28/210 (13.3%) in the IRIS and non-IRIS groups, respectively (p = 0.14). CONCLUSIONS: TB-IRIS occurs frequently in persons with advanced HIV infection and in those presenting with extra-pulmonary TB lesions, without influencing subsequent TB treatment outcomes.","author":[{"propositions":[],"lastnames":["Narendran"],"firstnames":["Gopalan"],"suffixes":[]},{"propositions":[],"lastnames":["Jyotheeswaran"],"firstnames":["Keerthana"],"suffixes":[]},{"propositions":[],"lastnames":["Senguttuvan"],"firstnames":["Thirumaran"],"suffixes":[]},{"propositions":[],"lastnames":["Vinhaes"],"firstnames":["Caian"],"suffixes":[]},{"propositions":[],"lastnames":["Santhanakrishnan"],"firstnames":["Ramesh"],"suffixes":[]},{"propositions":[],"lastnames":["Manoharan"],"firstnames":["Tamizhselvan"],"suffixes":[]},{"propositions":[],"lastnames":["Selvaraj"],"firstnames":["Anbhalagan"],"suffixes":[]},{"propositions":[],"lastnames":["Chandrasekaran"],"firstnames":["Padmapriyadarsini"],"suffixes":[]},{"propositions":[],"lastnames":["Menon"],"firstnames":["Pradeep"],"suffixes":[]},{"propositions":[],"lastnames":["Bhavani"],"firstnames":["Kannabiran"],"suffixes":[]},{"propositions":[],"lastnames":["Reddy"],"firstnames":["Devarajulu"],"suffixes":[]},{"propositions":[],"lastnames":["Narayanan"],"firstnames":["Ravichandran"],"suffixes":[]},{"propositions":[],"lastnames":["Subramanyam"],"firstnames":["Balaji"],"suffixes":[]},{"propositions":[],"lastnames":["Sathyavelu"],"firstnames":["Sekhar"],"suffixes":[]},{"propositions":[],"lastnames":["Krishnaraja"],"firstnames":["Raja"],"suffixes":[]},{"propositions":[],"lastnames":["Kalirajan"],"firstnames":["Pownraj"],"suffixes":[]},{"propositions":[],"lastnames":["Angamuthu"],"firstnames":["Dhanalakshmi"],"suffixes":[]},{"propositions":[],"lastnames":["Susaimuthu"],"firstnames":["Stella","Mary"],"suffixes":[]},{"propositions":[],"lastnames":["Ganesan"],"firstnames":["Ranjit"],"suffixes":[]},{"propositions":[],"lastnames":["Tripathy"],"firstnames":["Srikanth"],"suffixes":[]},{"propositions":[],"lastnames":["Swaminathan"],"firstnames":["Soumya"],"suffixes":[]},{"propositions":[],"lastnames":["Andrade"],"firstnames":["Bruno","B"],"suffixes":[]}],"doi":"10.1016/j.ijid.2020.06.097","file":":C$\\$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Narendran et al. - 2020 - Characteristics of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome and its inf.pdf:pdf","issn":"1201-9712","journal":"International Journal of Infectious Diseases","keywords":"HIV,IRIS,OA,anti-TB treatment,antiretroviral therapy,fund_not_ack,original,paradoxical reaction,tuberculosis","mendeley-tags":"OA,fund_not_ack,original","month":"sep","pages":"261–267","pmid":"32623087","publisher":"Elsevier","title":"Characteristics of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome and its influence on tuberculosis treatment outcomes in persons living with HIV","url":"https://doi.org/10.1016/j.ijid.2020.06.097","volume":"98","year":"2020","bibtex":"@article{Narendran2020,\r\nabstract = {OBJECTIVE: Tuberculosis (TB)-associated immune reconstitution inflammatory Syndrome (IRIS) influence on TB treatment outcomes and its risk factors were investigated among persons with HIV coinfected with TB. METHODS: Newly diagnosed, culture-confirmed, pulmonary TB patients with HIV, enrolled in a clinical trial (NCT00933790) were retrospectively analyzed for IRIS occurrence. Risk factors and TB outcomes (for up to 18 months after initiation of anti-TB treatment [ATT]) were compared between patients experiencing IRIS (IRIS group) and those who did not (Non-IRIS group). RESULTS: TB-IRIS occurred in 28{\\%} (82/292) of patients. Significant baseline risk factors predisposing to TB-IRIS occurrence in univariate analysis were lower CD4(+) T-cell count, CD4/CD8 ratio, hemoglobin levels, as well as presence of extra-pulmonary TB focus and higher HIV viral load, with the last two retaining significance in the multivariate analysis. After 2 months of ATT commencement, sputum smear conversion was documented in 45/80 (56.2{\\%}) vs. 124/194 (63.9{\\%}) (p = 0.23), culture conversion was 75/80 (93.7{\\%}) vs. 178/194 (91.7{\\%}) (p = 0.57) and the median decline in viral load (log(10)copies/mm(3)) being 2.7 in the IRIS vs. 1.1 in the non-IRIS groups (p {\\textless} 0.0001), respectively. The unfavourable response to TB therapy was detected in 17/82 (20.7{\\%}) and 28/210 (13.3{\\%}) in the IRIS and non-IRIS groups, respectively (p = 0.14). 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