Tuberculosis-associated immune reconstitution inflammatory syndrome: case definitions for use in resource-limited settings.
Meintjes, Graeme;
Lawn, Stephen D;
Scano, Fabio;
Maartens, Gary;
French, Martyn A;
Worodria, William;
Elliott, Julian H;
Murdoch, David;
Wilkinson, Robert J;
Seyler, Catherine;
+8 more...John, Laurence;
van der Loeff, Maarten Schim;
Reiss, Peter;
Lynen, Lut;
Janoff, Edward N;
Gilks, Charles;
Colebunders, Robert;
International Network for the Study of HIV-associated IRIS;
(2008)
Tuberculosis-associated immune reconstitution inflammatory syndrome: case definitions for use in resource-limited settings.
The Lancet infectious diseases, 8 (8).
pp. 516-523.
ISSN 1473-3099
DOI: https://doi.org/10.1016/S1473-3099(08)70184-1
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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.
