Frequency, severity and duration of immune reconstitution events in HIV-related tuberculosis

William Burman, Stephen Weis, A. Vernon, A. Khan, D. Benator, B. Jones, C. Silva, B. King, C. LaHart, B. Mangura, M. Weiner, W. El-Sadr

Research output: Contribution to journalArticle

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Abstract

SETTING: Patients were enrolled in a prospective trial of rifabutin-based tuberculosis (TB) treatment for human immunodeficiency virus related TB. Antiretroviral therapy (ART) was encouraged, but not required. OBJECTIVE: To evaluate the frequency, risk factors and duration of immune reconstitution events. DESIGN: Patients were prospectively evaluated for immune reconstitution events, and all adverse event reports were reviewed to identify possible unrecognized events. RESULTS: Of 169 patients, 25 (15%) developed immune reconstitution events related to TB. All 25 were among the 137 patients who received ART during TB treatment, so the frequency in this subgroup was 18% (25/137). Risk factors for an immune reconstitution event in multivariate analysis were Black race, the presence of extra-pulmonary TB and a shorter interval from initiation of TB treatment to initiation of ART. The most common clinical manifestations were fever (64%), new or worsening adenopathy (52%) and worsening pulmonary infiltrates (40%). Twelve patients (48%) were hospitalized for a median of 7 days, six underwent surgery and 11 had needle aspiration. The median duration of events was 60 days (range 11-442). CONCLUSION: Immune reconstitution events were common among patients receiving ART during TB treatment, produced substantial morbidity and had a median duration of 2 months.

Original languageEnglish
Pages (from-to)1282-1289
Number of pages8
JournalInternational Journal of Tuberculosis and Lung Disease
Volume11
Issue number12
StatePublished - 1 Dec 2007

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Tuberculosis
HIV
Therapeutics
Rifabutin
Pulmonary Tuberculosis
Needles
Fever
Multivariate Analysis
Morbidity
Lung

Keywords

  • Antiretroviral therapy
  • HIV
  • Immune reconstitution
  • Tuberculosis

Cite this

Burman, W., Weis, S., Vernon, A., Khan, A., Benator, D., Jones, B., ... El-Sadr, W. (2007). Frequency, severity and duration of immune reconstitution events in HIV-related tuberculosis. International Journal of Tuberculosis and Lung Disease, 11(12), 1282-1289.
Burman, William ; Weis, Stephen ; Vernon, A. ; Khan, A. ; Benator, D. ; Jones, B. ; Silva, C. ; King, B. ; LaHart, C. ; Mangura, B. ; Weiner, M. ; El-Sadr, W. / Frequency, severity and duration of immune reconstitution events in HIV-related tuberculosis. In: International Journal of Tuberculosis and Lung Disease. 2007 ; Vol. 11, No. 12. pp. 1282-1289.
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Burman, W, Weis, S, Vernon, A, Khan, A, Benator, D, Jones, B, Silva, C, King, B, LaHart, C, Mangura, B, Weiner, M & El-Sadr, W 2007, 'Frequency, severity and duration of immune reconstitution events in HIV-related tuberculosis', International Journal of Tuberculosis and Lung Disease, vol. 11, no. 12, pp. 1282-1289.

Frequency, severity and duration of immune reconstitution events in HIV-related tuberculosis. / Burman, William; Weis, Stephen; Vernon, A.; Khan, A.; Benator, D.; Jones, B.; Silva, C.; King, B.; LaHart, C.; Mangura, B.; Weiner, M.; El-Sadr, W.

In: International Journal of Tuberculosis and Lung Disease, Vol. 11, No. 12, 01.12.2007, p. 1282-1289.

Research output: Contribution to journalArticle

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T1 - Frequency, severity and duration of immune reconstitution events in HIV-related tuberculosis

AU - Burman, William

AU - Weis, Stephen

AU - Vernon, A.

AU - Khan, A.

AU - Benator, D.

AU - Jones, B.

AU - Silva, C.

AU - King, B.

AU - LaHart, C.

AU - Mangura, B.

AU - Weiner, M.

AU - El-Sadr, W.

PY - 2007/12/1

Y1 - 2007/12/1

N2 - SETTING: Patients were enrolled in a prospective trial of rifabutin-based tuberculosis (TB) treatment for human immunodeficiency virus related TB. Antiretroviral therapy (ART) was encouraged, but not required. OBJECTIVE: To evaluate the frequency, risk factors and duration of immune reconstitution events. DESIGN: Patients were prospectively evaluated for immune reconstitution events, and all adverse event reports were reviewed to identify possible unrecognized events. RESULTS: Of 169 patients, 25 (15%) developed immune reconstitution events related to TB. All 25 were among the 137 patients who received ART during TB treatment, so the frequency in this subgroup was 18% (25/137). Risk factors for an immune reconstitution event in multivariate analysis were Black race, the presence of extra-pulmonary TB and a shorter interval from initiation of TB treatment to initiation of ART. The most common clinical manifestations were fever (64%), new or worsening adenopathy (52%) and worsening pulmonary infiltrates (40%). Twelve patients (48%) were hospitalized for a median of 7 days, six underwent surgery and 11 had needle aspiration. The median duration of events was 60 days (range 11-442). CONCLUSION: Immune reconstitution events were common among patients receiving ART during TB treatment, produced substantial morbidity and had a median duration of 2 months.

AB - SETTING: Patients were enrolled in a prospective trial of rifabutin-based tuberculosis (TB) treatment for human immunodeficiency virus related TB. Antiretroviral therapy (ART) was encouraged, but not required. OBJECTIVE: To evaluate the frequency, risk factors and duration of immune reconstitution events. DESIGN: Patients were prospectively evaluated for immune reconstitution events, and all adverse event reports were reviewed to identify possible unrecognized events. RESULTS: Of 169 patients, 25 (15%) developed immune reconstitution events related to TB. All 25 were among the 137 patients who received ART during TB treatment, so the frequency in this subgroup was 18% (25/137). Risk factors for an immune reconstitution event in multivariate analysis were Black race, the presence of extra-pulmonary TB and a shorter interval from initiation of TB treatment to initiation of ART. The most common clinical manifestations were fever (64%), new or worsening adenopathy (52%) and worsening pulmonary infiltrates (40%). Twelve patients (48%) were hospitalized for a median of 7 days, six underwent surgery and 11 had needle aspiration. The median duration of events was 60 days (range 11-442). CONCLUSION: Immune reconstitution events were common among patients receiving ART during TB treatment, produced substantial morbidity and had a median duration of 2 months.

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KW - HIV

KW - Immune reconstitution

KW - Tuberculosis

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