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
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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
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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
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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
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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
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The Rainbow of IRIS in HIV, 26th July 2012
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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
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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
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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
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Acknowledgments
The Rainbow of IRIS in HIV, 26th July 2012
Prof. R Colebunders
Joseph Sempa
All patients
M-MJAP