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Tuberculosis Immune Reconstitution Inflammatory Syndrome in children initiating Antiretroviral Therapy for HIV infection: A systematic literature review.

Publication ,  Journal Article
Link-Gelles, R; Moultrie, H; Sawry, S; Murdoch, D; Van Rie, A
Published in: Pediatr Infect Dis J
May 2014

BACKGROUND: People with HIV initiating combination antiretroviral therapy are at risk for tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS). While this syndrome has been well researched in adults, little is known about the incidence, case fatality, underlying immunopathology and treatment approaches in children. METHODS: Major databases were searched for articles related to TB-IRIS in children. Data were abstracted using standardized forms. RESULTS: Thirteen studies were identified: 6 retrospective and 2 prospective cohort studies, 1 cross-sectional study, 3 case reports and 1 case series. In total, 303 cases of TB-IRIS were described, of which 270 were unmasking TB-IRIS, 12 paradoxical TB-IRIS and 21 were not classifiable due to lack of key information. None of the cohort studies had investigation of TB-IRIS as its primary aim. Nine studies were from Africa, 3 from Asia and 1 from Latin America. Age at cART initiation (reported by 12 studies) ranged from 1 month to 16 years. Median time from start of cART to IRIS diagnosis (reported by 8 studies) ranged from 8 days to 16 weeks. Few deaths attributable to TB-IRIS were recorded. Treatment was only discussed in 2 case studies, both of which reported children receiving corticosteroids. No studies evaluated risk factors for, or immunopathogenesis of, pediatric TB-IRIS. CONCLUSIONS: There is a paucity of information available on TB-IRIS in children. Future research assessing incidence, risk factors, case fatality and optimal treatment or prevention strategies of TB-IRIS is needed.

Duke Scholars

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Published In

Pediatr Infect Dis J

DOI

EISSN

1532-0987

Publication Date

May 2014

Volume

33

Issue

5

Start / End Page

499 / 503

Location

United States

Related Subject Headings

  • Tuberculosis
  • Risk Factors
  • Pediatrics
  • Mortality
  • Latin America
  • Infant
  • Incidence
  • Immune Reconstitution Inflammatory Syndrome
  • Humans
  • HIV Infections
 

Citation

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ICMJE
MLA
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Link-Gelles, R., Moultrie, H., Sawry, S., Murdoch, D., & Van Rie, A. (2014). Tuberculosis Immune Reconstitution Inflammatory Syndrome in children initiating Antiretroviral Therapy for HIV infection: A systematic literature review. Pediatr Infect Dis J, 33(5), 499–503. https://doi.org/10.1097/INF.0000000000000142
Link-Gelles, Ruth, Harry Moultrie, Shobna Sawry, David Murdoch, and Annelies Van Rie. “Tuberculosis Immune Reconstitution Inflammatory Syndrome in children initiating Antiretroviral Therapy for HIV infection: A systematic literature review.Pediatr Infect Dis J 33, no. 5 (May 2014): 499–503. https://doi.org/10.1097/INF.0000000000000142.
Link-Gelles R, Moultrie H, Sawry S, Murdoch D, Van Rie A. Tuberculosis Immune Reconstitution Inflammatory Syndrome in children initiating Antiretroviral Therapy for HIV infection: A systematic literature review. Pediatr Infect Dis J. 2014 May;33(5):499–503.
Link-Gelles, Ruth, et al. “Tuberculosis Immune Reconstitution Inflammatory Syndrome in children initiating Antiretroviral Therapy for HIV infection: A systematic literature review.Pediatr Infect Dis J, vol. 33, no. 5, May 2014, pp. 499–503. Pubmed, doi:10.1097/INF.0000000000000142.
Link-Gelles R, Moultrie H, Sawry S, Murdoch D, Van Rie A. Tuberculosis Immune Reconstitution Inflammatory Syndrome in children initiating Antiretroviral Therapy for HIV infection: A systematic literature review. Pediatr Infect Dis J. 2014 May;33(5):499–503.

Published In

Pediatr Infect Dis J

DOI

EISSN

1532-0987

Publication Date

May 2014

Volume

33

Issue

5

Start / End Page

499 / 503

Location

United States

Related Subject Headings

  • Tuberculosis
  • Risk Factors
  • Pediatrics
  • Mortality
  • Latin America
  • Infant
  • Incidence
  • Immune Reconstitution Inflammatory Syndrome
  • Humans
  • HIV Infections