Document Detail


Frequency, severity and duration of immune reconstitution events in HIV-related tuberculosis.
MedLine Citation:
PMID:  18229435     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
SETTING: Patients were enrolled in a prospective trial of rifabutin-based tuberculosis (TB) treatment for human immunodeficiency virus related TB. Antiretroviral therapy (ART) was encouraged, but not required. OBJECTIVE: To evaluate the frequency, risk factors and duration of immune reconstitution events. DESIGN: Patients were prospectively evaluated for immune reconstitution events, and all adverse event reports were reviewed to identify possible unrecognized events. RESULTS: Of 169 patients, 25 (15%) developed immune reconstitution events related to TB. All 25 were among the 137 patients who received ART during TB treatment, so the frequency in this subgroup was 18% (25/137). Risk factors for an immune reconstitution event in multivariate analysis were Black race, the presence of extra-pulmonary TB and a shorter interval from initiation of TB treatment to initiation of ART. The most common clinical manifestations were fever (64%), new or worsening adenopathy (52%) and worsening pulmonary infiltrates (40%). Twelve patients (48%) were hospitalized for a median of 7 days, six underwent surgery and 11 had needle aspiration. The median duration of events was 60 days (range 11-442). CONCLUSION: Immune reconstitution events were common among patients receiving ART during TB treatment, produced substantial morbidity and had a median duration of 2 months.
Authors:
W Burman; S Weis; A Vernon; A Khan; D Benator; B Jones; C Silva; B King; C LaHart; B Mangura; M Weiner; W El-Sadr
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease     Volume:  11     ISSN:  1027-3719     ISO Abbreviation:  Int. J. Tuberc. Lung Dis.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2008-01-29     Completed Date:  2008-03-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706389     Medline TA:  Int J Tuberc Lung Dis     Country:  France    
Other Details:
Languages:  eng     Pagination:  1282-9     Citation Subset:  IM    
Affiliation:
Denver Public Health and the University of Colorado Health Sciences Center, Denver, Colorado 80204, USA. bburman@dhha.org
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / drug therapy,  immunology*
Adult
Antiretroviral Therapy, Highly Active / adverse effects*
Antitubercular Agents / adverse effects,  therapeutic use*
Chi-Square Distribution
Female
Humans
Logistic Models
Male
Middle Aged
Prospective Studies
Rifabutin / adverse effects,  therapeutic use*
Risk Factors
Severity of Illness Index
Treatment Outcome
Tuberculosis / drug therapy*,  immunology*
Chemical
Reg. No./Substance:
0/Antitubercular Agents; 72559-06-9/Rifabutin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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