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Title
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Antiretroviral treatment-associated tuberculosis in a prospective cohort of HIV-infected patients starting ART
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Author
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Abstract
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| Commencement of antiretroviral treatment (ART) in severely immunosuppressed HIV-infected persons is associated with unmasking of subclinical disease. The subset of patients that are diagnosed with tuberculosis (TB) disease while on ART have been classified as ART-associated TB. Few studies have reported the incidence of ART-associated TB and unmasking TB-IRIS according to the International Network for the Study of HIV-Associated IRIS (INSHI) consensus definition. To determine the incidence and predictors of ART-associated TB, we screened 219 patients commencing ART at the Infectious Diseases Clinic in Kampala, Uganda for TB by symptoms, sputum microscopy, and chest X-rays and followed them for one year. Fourteen (6.4%) patients were diagnosed with TB during followup. Eight (3.8%) patients had ART-associated TB (incidence rate of 4.3 per 100 person years); of these, three patients fulfilled INSHI criteria for unmasking TB-associated IRIS (incidence rate of 1.6 per 100 person years). A body mass index of less than 18.5 kg/m2 BMI (HR 5.85 95% CI 1.2427.46, 𝑃 = . 0 2 5 ) and a C-reactive protein greater than 5 mg/L (HR 8.23 95% CI 1.3638.33, 𝑃 = . 0 2 0 ) were risk factors for ART-associated TB at multivariate analysis. In conclusion, with systematic TB screening (including culture and chest X-ray), the incidence of ART-associated TB is relatively low in settings with high HIV and TB prevalence. |
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Language
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English
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Source (journal)
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Clinical and developmental immunology. - -
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Publication
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Taylor
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2011
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ISSN
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1740-2522
1740-2530
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DOI
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10.1155/2011/758350
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Volume/pages
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(2011)
, p. 758350,1-758350,9
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Article Reference
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758350
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ISI
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000286249900001
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Medium
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E-only publicatie
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Full text (Publisher's DOI)
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Full text (open access)
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