ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Lung Injury on Antiretroviral Therapy in Adults With Human Immunodeficiency Virus/Tuberculosis.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 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
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Multimorbidity and the risk of post-tuberculosis lung disease: a systematic review and meta-analysis.BMJ global health · 2026Pooled it
- Trial
- Clinical and transcriptomic risk factors for post-tuberculosis lung disease in a cohort of Kenyan adults.American journal of respiratory and critical care medicine · 2026Observational
- Pulmonary function impairment patterns and their clinical correlates in patients with pulmonary tuberculosis complicated by pulmonary infection: a single-center retrospective cross-sectional study.Frontiers in medicine · 2026Article
- Post-tuberculosis lung disease: towards prevention, diagnosis, and care.The Lancet. Respiratory medicine · 2025Review
- Pretreatment Chest X-ray Scores and HIV Serostatus Are Associated with Lung Function at Tuberculosis Cure.Annals of the American Thoracic Society · 2025Article
- Potential Utility of C-reactive Protein for Tuberculosis Risk Stratification Among Patients With Non-Meningitic Symptoms at HIV Diagnosis in Low- and Middle-income Countries.Open forum infectious diseases · 2024Article
- Circulating Biomarkers, Fraction of Exhaled Nitric Oxide, and Lung Function in Patients With Human Immunodeficiency Virus and Tuberculosis.The Journal of infectious diseases · 2024Article
- Lung function and collagen 1a levels are associated with changes in 6 min walk test distance during treatment of TB among HIV-infected adults: a prospective cohort study.BMC pulmonary medicine · 2023Article
- Article
- Gene expression signatures identify biologically and clinically distinct tuberculosis endotypes.The European respiratory journal · 2022Article
- Perspectives for systems biology in the management of tuberculosis.European respiratory review : an official journal of the European Respiratory Society · 2021Review
- Pulmonary restriction predicts long-term pulmonary impairment in people with HIV and tuberculosis.BMC pulmonary medicine · 2021Article
- A Common NLRC4 Gene Variant Associates With Inflammation and Pulmonary Function in Human Immunodeficiency Virus and Tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Declines in Lung Function After Antiretroviral Therapy Initiation in Adults With Human Immunodeficiency Virus and Tuberculosis: A Potential Manifestation of Respiratory Immune Reconstitution Inflammatory Syndrome.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- The effect of HIV-associated tuberculosis, tuberculosis-IRIS and prednisone on lung function.The European respiratory journal · 2020Article
- Patient outcomes associated with post-tuberculosis lung damage in Malawi: a prospective cohort study.Thorax · 2020Article
Corrections and comments
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Authors and funding
15 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundImmune restoration on antiretroviral therapy (ART) can drive inflammation in people living with human immunodeficiency virus (HIV) who have pulmonary tuberculosis (TB), but its effects on the lungs have not been assessed. We evaluated associations between pulmonary inflammation, recovery of pathogen-specific CD4 T-cell function, and lung injury prior to and after ART initiation in adults with HIV and pulmonary TB.
methodsThis was a prospective cohort study in South Africa, following adults with HIV and pulmonary TB prior to and up to 48 weeks after ART initiation. Pulmonary-specific inflammation was defined as total glycolytic activity (TGA) on [18]F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) at baseline and 4 weeks after ART initiation. Spirometry, respiratory symptom tests, and flow cytometry were performed at the same times to assess lung involvement and the frequency of mycobacteria-specific CD4 T-cells. In addition, we evaluated lung function longitudinally up to 48 weeks after ART initiation.
resultsGreater lung TGA on FDG PET-CT was associated with worse lung function and respiratory symptoms prior to ART initiation, and nearly half of subjects experienced worsening lung inflammation and lung function at Week 4 of ART. Worsening Week 4 lung inflammation and pulmonary function were both associated with greater increases in pathogen-specific functional CD4 T-cell responses on ART, and early decreases in lung function were independently associated with persistently lower lung function months after TB treatment completion.
conclusionsIncreases in pulmonary inflammation and decreases in lung function are common on ART, relate to greater ART-mediated CD4 T-cell restoration, and are associated with the persistent impairment of lung function in individuals with HIV/TB.
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Registered trials
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