Kumar S Ramesh, Gopalan Narendran, Patrawalla Paru, Menon Pradeep, Mayer Kenneth, Swaminathan Soumya
Tuberculosis Research Centre (ICMR), Chennai, India.
Int J STD AIDS. 2012 Jun;23(6):419-23. doi: 10.1258/ijsa.2009.009439.
We conducted a nested case-control study in a cohort of patients initiating antiretroviral therapy (ART) to identify risk factors and common manifestations of immune reconstitution inflammatory syndrome (IRIS) and to validate the Robertson criteria for IRIS prediction. HIV-infected patients at the Tuberculosis Research Centre clinics, Chennai and Madurai, India, initiating ART between July 2004 and June 2005 were prospectively studied. Of 97 patients (62% men, median age 32 years, median CD4 count 63 cells/μL) included, 34 developed IRIS. IRIS was more common in patients with a prior history of tuberculosis (74% versus 52%, P = 0.04), median time to development was 46 days and the sensitivity and specificity of the Robertson criteria to predict IRIS were 91% and 22%, respectively. In this population, IRIS was a common event, more so among patients with prior tuberculosis, and neither the rate of CD4 increase nor the Robertson criteria were useful in predicting its development.
我们在一组开始抗逆转录病毒治疗（ART）的患者中进行了一项巢式病例对照研究，以确定免疫重建炎症综合征（IRIS）的危险因素和常见表现，并验证用于预测IRIS的罗伯逊标准。对印度金奈和马杜赖结核病研究中心诊所中2004年7月至2005年6月期间开始接受ART治疗的HIV感染患者进行了前瞻性研究。纳入的97例患者（62%为男性，中位年龄32岁，中位CD4细胞计数为63个/μL）中，34例发生了IRIS。IRIS在有结核病既往史的患者中更为常见（74%对52%，P = 0.04），发生的中位时间为46天，罗伯逊标准预测IRIS的敏感性和特异性分别为91%和22%。在该人群中，IRIS是常见事件，在有既往结核病的患者中更常见，CD4增加率和罗伯逊标准均无助于预测其发生。
