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Burman W, Weis S, Vernon A, et al. Frequency, severity and duration of immune reconstitution events in HIV-related tuberculosis. Int J Tuberc Lung Dis 2007; 11:1282-1289. This prospective study of patients starting cART while on TB treatment, documented 25 TB-IRIS events. The need for hospitalization and therapeutic procedures was appreciable in these patients indicating that TB-IRIS may be associated with significant morbidity.
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Manabe YC, Campbell JD, Sydnor E, Moore RD. Immune reconstitution inflammatory syndrome: risk factors and treatment implications. J Acquir Immune Defic Syndr 2007; 46:456-462. This case-control study in an American cART cohort provides novel insights into the risk factors associated with IRIS. Experience with the use of corticosteroids to treat IRIS is reported. Corticosteroids were predominantly used for mycobacterial IRIS and some patients required prolonged therapy.
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French MA. Disorders of immune reconstitution in patients with HIV infection responding to antiretroviral therapy. Curr HIV/AIDS Rep 2007; 4:16-21. An important conceptual paper that categorises the various disorders of immune reconstitution that may occur in HIV-infected patients on cART.
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Schiffer JT, Sterling TR. Timing of antiretroviral therapy initiation in tuberculosis patients with AIDS: a decision analysis. J Acquir Immune Defic Syndr 2007; 44:229-234. The first study to use a modeling approach to estimate the risks associated with early versus delayed initiation of cART in patients with TB. In the absence of clinical trials data regarding this issue, this study serves as a useful guide emphasizing the mortality benefit of not delaying cART, despite the higher risk of IRIS.
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Schiffer JT, Sterling TR. Timing of antiretroviral therapy initiation in tuberculosis patients with AIDS: a decision analysis. J Acquir Immune Defic Syndr 2007; 44:229-234. The first study to use a modeling approach to estimate the risks associated with early versus delayed initiation of cART in patients with TB. In the absence of clinical trials data regarding this issue, this study serves as a useful guide emphasizing the mortality benefit of not delaying cART, despite the higher risk of IRIS.
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Study from Cambodia which demonstrates the value of serum cryptococcal antigen testing as a screening tool to exclude cryptococcal disease before the start of cART
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Micol R, Lortholary O, Sar B, et al. Prevalence, determinants of positivity, and clinical utility of cryptococcal antigenemia in Cambodian HIV-infected patients. J Acquir Immune Defic Syndr 2007; 45:555-559. Study from Cambodia which demonstrates the value of serum cryptococcal antigen testing as a screening tool to exclude cryptococcal disease before the start of cART.
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