{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:17:44Z","timestamp":1789647464211,"version":"4.0.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2012,7,1]],"date-time":"2012-07-01T00:00:00Z","timestamp":1341100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Antiviral Therapy"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Here, we aimed to determine the clinical spectrum, predictors and outcomes of paradoxical tuberculosis-immune reconstitution inflammatory syndrome (TB-IRIS) in a resource-limited setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a prospective cohort, we studied 254 patients with tuberculosis and HIV coinfection commencing antiretroviral therapy (ART). We identified patients with TB-IRIS using the International Network for Studies Against HIV-Associated IRIS (INSHI) case definition. Risk factors and clinical outcomes of TB-IRIS were determined and reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 53 (21%) patients developed TB-IRIS a median of 2 weeks (IQR 12\u201322 days) after starting ART. The majority of the patients (70%) with TB-IRIS had extrapulmonary manifestations of TB-IRIS. In a multiple logistic regression model, baseline haemoglobin &lt;100 g\/l (OR 2.23 [95% CI 1.08\u20134.60]; P=0.031) and baseline CD4\n                      <jats:sup>+<\/jats:sup>\n                      T-cell count &lt;50 cells\/ml (OR 4.13 [95% CI 1.80\u20139.51]; P=0.001) were significant predictors of IRIS. Seven additional patients fulfilled all INSHI criteria of TB-IRIS but had the episode of TB-IRIS later than 3 months after ART start.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TB-IRIS was a frequent reason for clinical deterioration among patients with TB commencing ART but was not a primary contributor to mortality. Patients with advanced CD4 depletion and anaemia were at increased risk of TB-IRIS. Some patients developed late-onset TB-IRIS and\/or a recurrent TB-IRIS episode.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3851\/imp2108","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T10:44:20Z","timestamp":1339497860000},"page":"841-848","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":37,"title":["Clinical Spectrum, Risk Factors and Outcome of Immune Reconstitution Inflammatory Syndrome in Patients with Tuberculosis\u2013HIV Coinfection"],"prefix":"10.1177","volume":"17","author":[{"given":"William","family":"Worodria","sequence":"first","affiliation":[{"name":"Department of Medicine, Makerere University College of Health Sciences, Mulago Hospital, Kampala, Uganda"},{"name":"University of Antwerp, Antwerp, Belgium"},{"name":"Infectious diseases Network for Treatment and Research in Africa, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris","family":"Menten","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marguerite","family":"Massinga-Loembe","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Mazakpwe","sequence":"additional","affiliation":[{"name":"Infectious diseases Network for Treatment and Research in Africa, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danstan","family":"Bagenda","sequence":"additional","affiliation":[{"name":"Makerere School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Koole","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet","family":"Mayanja-Kizza","sequence":"additional","affiliation":[{"name":"Department of Medicine, Makerere University College of Health Sciences, Mulago Hospital, Kampala, Uganda"},{"name":"Infectious diseases Network for Treatment and Research in Africa, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Kestens","sequence":"additional","affiliation":[{"name":"University of Antwerp, Antwerp, Belgium"},{"name":"Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Mugerwa","sequence":"additional","affiliation":[{"name":"Department of Medicine, Makerere University College of Health Sciences, Mulago Hospital, Kampala, Uganda"},{"name":"Infectious diseases Network for Treatment and Research in Africa, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Reiss","sequence":"additional","affiliation":[{"name":"Academic Medical Centre, Department of Global Health and Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Colebunders","sequence":"additional","affiliation":[{"name":"University of Antwerp, Antwerp, Belgium"},{"name":"Infectious diseases Network for Treatment and Research in Africa, Kampala, Uganda"},{"name":"Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the TB-IRIS Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2012,7,1]]},"reference":[{"key":"bibr1-IMP2108","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.9.1009"},{"key":"bibr2-IMP2108","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000230521.86964.86"},{"key":"bibr3-IMP2108","doi-asserted-by":"crossref","unstructured":"Blanc F.X., Sok T., Laureillard D. Significant enhancement in survival with early (2 weeks) vs. late (8 weeks) initiation of highly active antiretroviral treatment (HAART) in severely immunosuppressed HIV-infected adults with newly diagnosed tuberculosis.\n                      XVIII International AIDS Conference\n                      . 18\u201323 July 2010, Vienna, Austria. Abstract THLBB106.","DOI":"10.1186\/1753-6561-5-S1-O11"},{"key":"bibr4-IMP2108","doi-asserted-by":"publisher","DOI":"10.1002\/eji.200838630"},{"key":"bibr5-IMP2108","doi-asserted-by":"publisher","DOI":"10.1086\/657082"},{"key":"bibr6-IMP2108","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e328302ebbb"},{"key":"bibr7-IMP2108","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-05-285080"},{"key":"bibr8-IMP2108","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000202648.18526.bf"},{"key":"bibr9-IMP2108","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.0804020"},{"key":"bibr10-IMP2108","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3282f4a607"},{"key":"bibr11-IMP2108","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1177\/135965350501000303","volume":"10","author":"Michailidis C.","year":"2005","journal-title":"Antivir Ther"},{"key":"bibr12-IMP2108","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181594c8c"},{"key":"bibr13-IMP2108","first-page":"1282","volume":"11","author":"Burman W.","year":"2007","journal-title":"Int J Tuberc Lung Dis"},{"key":"bibr14-IMP2108","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/239021"},{"key":"bibr15-IMP2108","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000161769.06158.8a"},{"key":"bibr16-IMP2108","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2009.05.016"},{"key":"bibr17-IMP2108","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(08)70184-1"},{"key":"bibr18-IMP2108","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3182255dc2"},{"key":"bibr19-IMP2108","unstructured":"World Health Organization. Improving the diagnosis and treatment of smear-negative pulmonary and extrapulmonary tuberculosis among adults and adolescents. Recommendations for HIV-prevalent and resource-constrained settings. (Accessed 21 August 2011.) Available from http:\/\/whqlibdoc.who.int\/hq\/2007\/WHO_HTM_TB_2007.379_eng.pdf."},{"key":"bibr20-IMP2108","unstructured":"Republic of Uganda Ministry of Health. National antiretroviral treatment and care guidelines for adults, adolescents, and children. (Updated July 2008. Accessed 31 August 2011.) Available from http:\/\/www.who.int\/hiv\/amds\/uganda_moh_treatment_guidelines.pdf."},{"key":"bibr21-IMP2108","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328011efac"},{"key":"bibr22-IMP2108","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32832f7b59"},{"key":"bibr23-IMP2108","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.158.1.9712001"},{"key":"bibr24-IMP2108","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.1.97"},{"key":"bibr25-IMP2108","doi-asserted-by":"publisher","DOI":"10.1086\/644784"},{"key":"bibr26-IMP2108","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(05)70140-7"},{"key":"bibr27-IMP2108","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0905848"},{"key":"bibr28-IMP2108","unstructured":"Abdool Karim S., Naidoo K., Padayatchi N. Optimal timing of ART during TB therapy: findings of the SAPiT Trial.\n                      18th Conference on Retroviruses and Opportunistic Infections\n                      . 27 February\u20132-March 2011, Boston, MA, USA. Abstract 39LB."},{"key":"bibr29-IMP2108","doi-asserted-by":"publisher","DOI":"10.1177\/1545109710361537"},{"key":"bibr30-IMP2108","unstructured":"Havlir D., Ive P., Kendall M. International randomized trial of immediate vs early ART in HIV+ patients treated for TB: ACTG 5221 STRIDE Study.\n                      18th Conference on Retroviruses and Opportunistic Infections\n                      . 27 February\u20132-March 2011, Boston, MA, USA. Abstract 38."},{"key":"bibr31-IMP2108","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2006.01.002"},{"key":"bibr32-IMP2108","unstructured":"Republic of Uganda Ministry of Health. Manual of the National Tuberculosis and Leprosy Programme. (Updated 2010. Accessed 13 June 2011.) Available from http:\/\/www.who.int\/hiv\/pub\/guidelines\/uganda_tb.pdf."},{"key":"bibr33-IMP2108","doi-asserted-by":"publisher","DOI":"10.1086\/425742"},{"key":"bibr34-IMP2108","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32833dfc68"},{"key":"bibr35-IMP2108","doi-asserted-by":"publisher","DOI":"10.1086\/598988"},{"key":"bibr36-IMP2108","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70026-8"},{"key":"bibr37-IMP2108","doi-asserted-by":"publisher","DOI":"10.1179\/acb.2007.022"},{"key":"bibr38-IMP2108","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70170-5"}],"container-title":["Antiviral Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3851\/IMP2108","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3851\/IMP2108","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:50:52Z","timestamp":1777380652000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.3851\/IMP2108"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,7]]},"references-count":38,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2012,7]]}},"alternative-id":["10.3851\/IMP2108"],"URL":"https:\/\/doi.org\/10.3851\/imp2108","relation":{},"ISSN":["1359-6535","2040-2058"],"issn-type":[{"value":"1359-6535","type":"print"},{"value":"2040-2058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,7]]}}}