late-outcomes of tb-iris
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Late-outcomes of TB-IRIS. William Worodria , MBChB , MMed , PhD Senior EDCTP Fellow Infectious Disease Institute, Kampala, Uganda Mulago Hospital & Complex, Kampala, Uganda. Study objective. - PowerPoint PPT PresentationTRANSCRIPT
Late-outcomes of TB-IRIS
William Worodria, MBChB, MMed, PhDSenior EDCTP Fellow
Infectious Disease Institute, Kampala, Uganda Mulago Hospital & Complex, Kampala, Uganda
The Rainbow of IRIS in HIV, 26th July 2012
Study objective
To determine if there are differences in treatment outcomes between TB-HIV co-infected patients with and without TB-IRIS:• CD4 changes with treatment•Mortality• Loss to follow up
The Rainbow of IRIS in HIV, 26th July 2012
Methodology Site: Mulago National TB treatment centre Design: Case-control design. Inclusion criteria:– ART naïve adult patients co-infected with TB-HIV
started on HAART (CD4<250) Exclusion criteria:– No treatment supporter– Severe liver/renal abnormalities
Cases: patients with TB-IRIS Controls: patients without TB-IRIS
-matched by baseline CD4 count (1:2)The Rainbow of IRIS in HIV,
26th July 2012
ResultsFrom December 2007 - July 2010, we enrolled 254 patients with TB-HIV starting ART
We identified:–61 cases of TB-IRIS and–122 controls (no TB-IRIS)
The Rainbow of IRIS in HIV, 26th July 2012
The Rainbow of IRIS in HIV, 26th July 2012
0tan28a5
66028
0tan5a5
6605
0tan11a5
66011
0tan17a5
66017
0tan23a5
66023
0tan7a5
66070tan28a566028
0tan19a566019
0tan10a566010
0tan1a56601
0tan21a566021
0tan12a566012
0tan3a56613
0tan23a566123
TB-IRISno TB-IRIS
Months of follow up
CD4
coun
ts (
cells
/µL)
Median CD4 counts of patients co-infected with TB-HIV on antiretroviral therapy
Treatment outcomesMortality:
6 (10%) patients with TB-IRIS died vs 18 (15%) without TB-IRIS
ORmortality = 0.60, 95% CI 0.21-1.70, (p= 0.34)
Loss to Follow up: 5 (8.2%) patients with TB-IRIS vs 10 (8.2%) without were lost to follow up
ORloss2fu = 1.00, 95% CI 0.33- 3.04, (p=1.00)
The Rainbow of IRIS in HIV, 26th July 2012
Conclusion
TB-IRIS in this study with a small sample size had no impact on outcomes
The Rainbow of IRIS in HIV, 26th July 2012
Acknowledgments
The Rainbow of IRIS in HIV, 26th July 2012
Prof. R Colebunders
Joseph Sempa
All patients
M-MJAP