Trial reportThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2011
Early antiretroviral treatment reduces risk of bacille Calmette-Guérin immune reconstitution adenitis.
Trial report in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
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Who cites it
26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV-1 infection 2015: optimizing health in preparation for adult life.HIV medicine · 2018Guideline
- A systemic review of tuberculosis with HIV coinfection in children.Pediatric radiology · 2017Pooled it
- Tuberculosis Immune Reconstitution Inflammatory Syndrome in children initiating Antiretroviral Therapy for HIV infection: A systematic literature review.The Pediatric infectious disease journal · 2014Pooled it
- Treating BCG-induced disease in children.The Cochrane database of systematic reviews · 2013Pooled it
- BCG vaccination induces HIV target cell activation in HIV-exposed infants in a randomized trial.JCI insight · 2017Trial
- Trial
- Delaying BCG vaccination until 8 weeks of age results in robust BCG-specific T-cell responses in HIV-exposed infants.The Journal of infectious diseases · 2015Trial
- Unmasking Bacillus Calmette-Guérin Immune Reconstitution Inflammatory Syndrome in a Perinatal HIV Transmission-A Case Report.Tropical medicine and infectious disease · 2025Article
- Severe BCG immune reconstitution inflammatory syndrome lymphadenitis successfully managed with pre-antiretroviral counseling and a non-surgical approach: a case report.AIDS research and therapy · 2024Article
- Developing tuberculosis vaccines for people with HIV: consensus statements from an international expert panel.The lancet. HIV · 2022Review
- BCG Vaccination and Mother-to-Infant Transmission of HIV.The Journal of infectious diseases · 2020Article
- Earlier Antiretroviral Therapy Initiation and Decreasing Mortality Among HIV-infected Infants Initiating Antiretroviral Therapy Within 3 Months of Age in South Africa, 2006-2017.The Pediatric infectious disease journal · 2020Article
- An Exclusively Skewed Distribution of Pediatric Immune Reconstitution Inflammatory Syndrome Toward the Female Sex Is Associated With Advanced Acquired Immune Deficiency Syndrome.Frontiers in pediatrics · 2019Article
- A prospective study of the immune reconstitution inflammatory syndrome (IRIS) in HIV-infected children from high prevalence countries.PloS one · 2019Observational
- Tuberculosis and HIV-An Update on the "Cursed Duet" in Children.Frontiers in pediatrics · 2019Review
- Immune Reconstitution Inflammatory Syndrome in children.SA journal of radiology · 2017Review
- CLINICAL MANAGEMENT OF LOCALIZED BCG ADVERSE EVENTS IN CHILDREN.Revista do Instituto de Medicina Tropical de Sao Paulo · 2016Article
- Reply to Thysen et al.The Journal of infectious diseases · 2015Article
- Targeting 90-90-90--don't leave children and adolescents behind.Journal of the International AIDS Society · 2015Article
- Tuberculosis: opportunities and challenges for the 90-90-90 targets in HIV-infected children.Journal of the International AIDS Society · 2015Review
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 2 countries.
Funding
Abstract
settingTwo centres in Soweto and Cape Town, South Africa.
objectiveTo assess the effects of timing of initiation of antiretroviral treatment (ART) and other factors on the risk of bacille Calmette-Guérin (BCG) related regional adenitis due to immune reconstitution inflammatory syndrome (BCG-IRIS) in human immunodeficiency virus (HIV) infected infants.
designHIV-infected infants aged 6-12 weeks with CD4 count ≥25% enrolled in the Children with HIV Early Antiretroviral Therapy (CHER) Trial received early (before 12 weeks) or deferred (after immunological or clinical progression) ART; infants with CD4 count <25% all received early ART. All received BCG vaccination after birth. Reactogenicity to BCG was assessed prospectively during routine study follow-up.
resultsOf 369 infants, 32 (8.7%) developed BCG-IRIS within 6 months of starting ART, 28 (88%) within 2 months after ART initiation. Of the 32 cases, 30 (93.8%) had HIV-1 RNA > 750 000 copies/ml at initiation. Incidence of BCG-IRIS was 10.9 and 54.3 per 100 person-years (py) among infants with CD4 count ≥25% at enrolment receiving early (at median age 7.4 weeks) vs. deferred (23.2 weeks) ART, respectively (HR 0.24, 95%CI 0.11-0.53, P < 0.001). Infants with CD4 count <25% receiving early ART had intermediate incidence (41.7/100 py). Low CD4 counts and high HIV-1 RNA at initiation were the strongest independent risk factors for BCG-IRIS.
conclusionsEarly ART initiation before immunological and/or clinical progression substantially reduces the risk of BCG-IRIS regional adenitis.
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Registered trials
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.