ArticleCurrent opinion in HIV and AIDS2018
The tuberculosis-associated immune reconstitution inflammatory syndrome: recent advances in clinical and pathogenesis research.
Article in Current opinion in HIV and AIDS, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 1 of them a synthesis 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.
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Who cites it
45 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.
- 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
- Incidence and Predictors of Tuberculosis-associated IRIS in People With HIV Treated for Tuberculosis: Findings From Reflate TB2 Randomized Trial.Open forum infectious diseases · 2024Trial
- Dolutegravir twice-daily dosing in children with HIV-associated tuberculosis: a pharmacokinetic and safety study within the open-label, multicentre, randomised, non-inferiority ODYSSEY trial.The lancet. HIV · 2022Trial
- Trial
- Prevalence and burden of HIV-TB co-infection among pregnant women: A systematic review and meta-analysis.Journal of Taibah University Medical Sciences · 2026Review
- Talaromycosis-associated immune reconstitution inflammatory syndrome exhibits immune dysregulation in patients with acquired immunodeficiency syndrome.PLoS neglected tropical diseases · 2026Article
- Expert consensus on the clinical management of HIV late presentation.Infectious diseases & immunity · 2026Article
- A Nomogram Predictive Model for Drug-Resistant Tuberculosis Detection by GeneXpert MTB/RIF Assay in Paediatric Patients.Infection and drug resistance · 2026Article
- Pial Laceration from a Dural Suture Causing Devastating Neurological Deficits.Acta neurochirurgica. Supplement · 2025Article
- Tuberculous compound palmar ganglion: unravelling a rare diagnosis.International journal of burns and trauma · 2025Article
- Primary lung tuberculosis mimicking metastatic lesions of resected shoulder osteosarcoma.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2024Article
- Immune recovery uveitis: a focus review.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2024Review
- Immune reconstitution inflammatory syndrome following treatment of cutaneous tuberculosis with rifampin, isoniazid, pyrazinamide, and ethambutol.JAAD case reports · 2024Article
- Paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome in initiating ART among HIV-Infected patients in China-risk factors and management.BMC infectious diseases · 2024Article
- Article
- Natural Killer Repertoire Restoration in TB/HIV Co-Infected Individuals Experienced an Immune Reconstitution Syndrome (CAMELIA Trial, ANRS 12153).Pathogens (Basel, Switzerland) · 2023Article
- A Review on Inflammasomes and Immune Checkpoints in Pre-Eclampsia Complicated with Tuberculosis and Human Immune Deficiency Virus.International journal of environmental research and public health · 2023Review
- Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome-An Extempore Game of Misfiring with Defense Arsenals.Pathogens (Basel, Switzerland) · 2023Review
- Systems biology approaches to investigate the role of granulomas in TB-HIV coinfection.Frontiers in immunology · 2022Review
- Adoption of evidence-informed guidelines in prescribing protease inhibitors for HIV-Tuberculosis co-infected patients on rifampicin and effects on HIV treatment outcomes in Uganda.BMC infectious diseases · 2021Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
Abstract
purpose of reviewAntiretroviral therapy (ART) is an essential, life-saving intervention for HIV infection. However, ART initiation is frequently complicated by the tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) in TB endemic settings. Here, we summarize the current understanding highlighting the recent evidence. RECENT
findingsThe incidence of paradoxical TB-IRIS is estimated at 18% (95% CI 16-21%), higher than previously reported and may be over 50% in high-risk groups. Early ART initiation in TB patients increases TB-IRIS risk by greater than two-fold, but is critical in TB patients with CD4 counts less than 50 cells/μl because it improves survival. There remains no validated diagnostic test for TB-IRIS, and biomarkers recently proposed are not routinely used. Prednisone initiated alongside ART in selected patients with CD4 less than 100 cells/μl reduced the risk of paradoxical TB-IRIS by 30% in a recent randomized-controlled trial (RCT) and was not associated with significant adverse effects. Effective also for treating paradoxical TB-IRIS, corticosteroids remain the only therapeutic intervention for TB-IRIS supported by RCT trial data. TB-IRIS pathogenesis studies implicate high antigen burden, innate immune cell cytotoxicity, inflammasome activation and dysregulated matrix metalloproteinases in the development of the condition. SUMMARY: Specific biomarkers would aid in identifying high-risk patients for interventions and a diagnostic test is needed. Clinicians should consider prednisone for TB-IRIS prevention in selected patients. Future research should focus on improving diagnosis and investigating novel therapeutic interventions, especially for patients in whom corticosteroid therapy is contraindicated.
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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.