SynthesisThe Lancet. Infectious diseases2010
Immune reconstitution inflammatory syndrome in patients starting antiretroviral therapy for HIV infection: a systematic review and meta-analysis.
Synthesis in The Lancet. Infectious diseases, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 342 papers, 5 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
342 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Paradoxical Reaction to Tuberculosis Therapy among HIV-Negative Children: A Systematic Review and Meta-Analysis.The American journal of tropical medicine and hygiene · 2024Pooled it
- Immune reconstitution inflammatory syndrome, a controversial burden in the East African context: a systematic review and meta-analysis.Frontiers in medicine · 2023Pooled it
- What is the optimum time to start antiretroviral therapy in people with HIV and tuberculosis coinfection? A systematic review and meta-analysis.Journal of the International AIDS Society · 2021Pooled it
- Mortality among pediatric patients on HIV treatment in sub-Saharan African countries: a systematic review and meta-analysis.BMC public health · 2019Pooled it
- Early versus delayed antiretroviral treatment in HIV-positive people with cryptococcal meningitis.The Cochrane database of systematic reviews · 2018Pooled it
- Causes and Timing of Mortality and Morbidity Among Late Presenters Starting Antiretroviral Therapy in the REALITY Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Trial
- Incidence of Tuberculosis Among HIV-Positive Individuals Initiating Antiretroviral Treatment at Higher CD4 Counts in the HPTN 071 (PopART) Trial in South Africa.Journal of acquired immune deficiency syndromes (1999) · 2018Trial
- Nevirapine- versus Efavirenz-based antiretroviral therapy regimens in antiretroviral-naive patients with HIV and Tuberculosis infections in India: a multi-centre study.BMC infectious diseases · 2017Trial
- Transient Increase in Herpes Simplex Virus Type 2 (HSV-2)-Associated Genital Ulcers Following Initiation of Antiretroviral Therapy in HIV/HSV-2-Coinfected Individuals.The Journal of infectious diseases · 2016Trial
- Vitamin D, D-dimer, Interferon γ, and sCD14 Levels are Independently Associated with Immune Reconstitution Inflammatory Syndrome: A Prospective, International Study.EBioMedicine · 2016Trial
- Tracing the patterns of HIV-1 transmission among people with different diagnosis status in Greece.Virus research · 2026Article
- Rapid recovery from near-fatal immune reconstitution inflammatory syndrome and acute respiratory distress syndrome following neutropenic recovery by cytokine adsorption.BMC pulmonary medicine · 2026Article
- Kaposi sarcoma in the era of immunodeficiency: challenges and opportunities for treatment and prevention.Annals of medicine and surgery (2012) · 2026Article
- Sarcoidosis-like reaction associated with tocilizumab in a patient with giant cell arteritis: a case based review.Rheumatology international · 2026Article
- Monocyte-Amplified Transcriptional Signatures of Human Diseases.bioRxiv : the preprint server for biology · 2026Article
- Kaposi Sarcoma-Associated Immune Reconstitution Inflammatory Syndrome (KS-IRIS) in Advanced HIV: Challenges in Managing Visceral Disease With Pericardial Involvement.Open forum infectious diseases · 2026Article
- Post-marketing safety profile of bictegravir/emtricitabine/tenofovir alafenamide: a FAERS pharmacovigilance study with EudraVigilance validation and mechanistic investigation of pancreatitis.Virology journal · 2026Article
- Prolonged Paradoxical TB-IRIS: 2 Case Reports and a Review of the Literature.Open forum infectious diseases · 2026Article
- Expert consensus on the clinical management of HIV late presentation.Infectious diseases & immunity · 2026Article
- Next-Generation HIV-1 Therapeutics in Co-Endemic Settings.Biomedicines · 2026Review
282 more citing papers are in PubMed but not listed here.
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7 authors.
Funding
Abstract
In patients with HIV-1 infection who are starting combination antiretroviral therapy (ART), the incidence of immune reconstitution inflammatory syndrome (IRIS) is not well defined. We did a meta-analysis to establish the incidence and lethality of the syndrome in patients with a range of previously diagnosed opportunistic infections, and examined the relation between occurrence and the degree of immunodeficiency. Systematic review identified 54 cohort studies of 13 103 patients starting ART, of whom 1699 developed IRIS. We calculated pooled cumulative incidences with 95% credibility intervals (CrI) by Bayesian methods and did a random-effects metaregression to analyse the relation between CD4 cell count and incidence of IRIS. In patients with previously diagnosed AIDS-defining illnesses, IRIS developed in 37.7% (95% CrI 26.6-49.4) of those with cytomegalovirus retinitis, 19.5% (6.7-44.8) of those with cryptococcal meningitis, 15.7% (9.7-24.5) of those with tuberculosis, 16.7% (2.3-50.7) of those with progressive multifocal leukoencephalopathy, and 6.4% (1.2-24.7) of those with Kaposi's sarcoma, and 12.2% (6.8-19.6) of those with herpes zoster. 16.1% (11.1-22.9) of unselected patients starting ART developed any type of IRIS. 4.5% (2.1-8.6) of patients with any type of IRIS died, 3.2% (0.7-9.2) of those with tuberculosis-associated IRIS died, and 20.8% (5.0-52.7) of those with cryptococcal meningitis died. Metaregression analyses showed that the risk of IRIS is associated with CD4 cell count at the start of ART, with a high risk in patients with fewer than 50 cells per microL. Occurrence of IRIS might therefore be reduced by initiation of ART before immunodeficiency becomes advanced.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.