Tuberculosis-associated Immune Reconstitution Inflammatory Syndrome: Case Definitions for Use in Resource-limited Settings

Overview

Journal Lancet Infect Dis

Specialty Infectious Diseases

Date 2008 Jul 26

PMID 18652998

Citations 315

Authors

Graeme Meintjes

Stephen D Lawn

Fabio Scano

Gary Maartens

Martyn A French

William Worodria

Julian H Elliott

David Murdoch

Robert J Wilkinson

Catherine Seyler

Laurence John

Maarten Schim van der Loeff

Peter Reiss

Lut Lynen

Edward N Janoff

Charles Gilks

Robert Colebunders

Affiliations

Soon will be listed here.

Abstract

The immune reconstitution inflammatory syndrome (IRIS) has emerged as an important early complication of antiretroviral therapy (ART) in resource-limited settings, especially in patients with tuberculosis. However, there are no consensus case definitions for IRIS or tuberculosis-associated IRIS. Moreover, previously proposed case definitions are not readily applicable in settings where laboratory resources are limited. As a result, existing studies on tuberculosis-associated IRIS have used a variety of non-standardised general case definitions. To rectify this problem, around 100 researchers, including microbiologists, immunologists, clinicians, epidemiologists, clinical trialists, and public-health specialists from 16 countries met in Kampala, Uganda, in November, 2006. At this meeting, consensus case definitions for paradoxical tuberculosis-associated IRIS, ART-associated tuberculosis, and unmasking tuberculosis-associated IRIS were derived, which can be used in high-income and resource-limited settings. It is envisaged that these definitions could be used by clinicians and researchers in a variety of settings to promote standardisation and comparability of data.

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