{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T19:24:19Z","timestamp":1788463459621,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:00:00Z","timestamp":1701993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002738","name":"Assistance Publique - H\u00f4pitaux de Paris","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021716","name":"Universit\u00e9 de Paris","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021716","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Immune reconstitution inflammatory syndrome (IRIS) affecting the central nervous system (CNS) is associated with poor outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To report on risk factors for CNS\u2010IRIS following tuberculous meningitis (TBM) in HIV\u2010negative patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective multicentre study, all HIV\u2010negative adult patients admitted between 2003 and 2021 with microbiologically proven TBM were included. The primary outcome measure was IRIS onset over follow\u2010up. Characteristics of patients who developed IRIS were described. Factors associated with IRIS were identified using a multivariable logistic regression procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010six patients (33.0 (27.0\u201344.3) years, 39 (69.6%) men) with microbiologically proven TBM were studied. All patients received antituberculosis treatment and 48 (<jats:italic>n<\/jats:italic> =\u200948\/56; 85.7%) steroids at TBM diagnosis. During a median follow\u2010up of 18.0 (12.0\u201327.3) months, IRIS occurred in 28 (<jats:italic>n<\/jats:italic> =\u200928\/56, 50.0%) patients, at a median time of 2.0 (1.0\u20133.0) months after antituberculosis treatment was started. IRIS involved the CNS in all but one case. Imaging revealed new (<jats:italic>n<\/jats:italic> =\u200923\/28, 82.1%) and\/or worsening (<jats:italic>n<\/jats:italic> =\u200921\/28; 75.0%) of previously recognised lesions. Multivariable analysis showed that meningeal enhancement on brain magnetic resonance imaging (MRI) (odds ratio (OR): 15.3; 95% confidence interval (CI): (1.19\u20131193.5)) at TBM diagnosis and high blood albumin level (OR: 1.21; 95% CI: (1.02\u20131.60)) were associated with the occurrence of CNS\u2010IRIS during follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CNS\u2010IRIS following TBM in non\u2010HIV patients appears frequent and severe. Meningeal enhancement on brain MRI at tuberculosis diagnosis is a risk factor for CNS\u2010IRIS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16295","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T18:44:40Z","timestamp":1702061080000},"page":"802-808","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Incidence, risk factors and treatment of central nervous system immune reconstitution inflammatory syndrome in <scp>non\u2010HIV<\/scp> patients with tuberculous meningitis: a multicentre observational study"],"prefix":"10.1111","volume":"54","author":[{"given":"Marie","family":"Robert","sequence":"first","affiliation":[{"name":"Service de M\u00e9decine Interne H\u00f4pital Bichat, Assistance Publique \u2013 H\u00f4pitaux de Paris (AP\u2010HP)  Paris 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