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Incidence and Predictors of Tuberculosis-associated IRIS in People With HIV Treated for Tuberculosis: Findings From Reflate TB2 Randomized Trial

dc.rights.licenseopenen_US
dc.contributor.authorCOELHO, Lara E
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorCHAZALLON, Corine
dc.contributor.authorLAUREILLARD, Didier
dc.contributor.authorESCADA, Rodrigo
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorN'TAKPE, Jean-Baptiste
dc.contributor.authorTIMANA, Isabelle
dc.contributor.authorMESSOU, Eugene
dc.contributor.authorEHOLIE, Serge
dc.contributor.authorKHOSA, Celso
dc.contributor.authorCHAU, Giang D
dc.contributor.authorCARDOSO, Sandra Wagner
dc.contributor.authorVELOSO, Valdilea G
dc.contributor.authorDELAUGERRE, Constance
dc.contributor.authorMOLINA, Jean-Michel
dc.contributor.authorGRINSZTEJN, Beatriz
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorMARCY, Olivier
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorDE CASTRO, Nathalie
dc.date.accessioned2024-04-30T15:19:32Z
dc.date.available2024-04-30T15:19:32Z
dc.date.issued2024-03-01
dc.identifier.issn2328-8957en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/199553
dc.description.abstractEnBACKGROUND: After antiretroviral therapy (ART) initiation, people with HIV (PWH) treated for tuberculosis (TB) may develop TB-associated immune reconstitution inflammatory syndrome (TB-IRIS). Integrase inhibitors, by providing a faster HIV-RNA decline than efavirenz, might increase the risk for this complication. We sought to assess incidence and determinants of TB-IRIS in PWH with TB on raltegravir- or efavirenz-based ART. METHODS: We conducted a secondary analysis of the Reflate TB 2 trial, which randomized ART-naive PWH on standard TB treatment, to receive raltegravir- or efavirenz-based ART. The primary objective was to evaluate the incidence of TB-IRIS. Incidence rate ratio comparing TB-IRIS incidence in each arm was calculated. Kaplan-Meier curves were used to compare TB-IRIS-free survival probabilities by ART arm. Cox regression models were fitted to analyze baseline characteristics associated with TB-IRIS. RESULTS: Of 460 trial participants, 453 from Brazil, Côte d'Ivoire, Mozambique, and Vietnam were included in this analysis. Baseline characteristics were median age 35 years (interquartile range [IQR], 29-43), 40% female, 69% pulmonary TB only, median CD4, 102 (IQR, 38-239) cells/mm³, and median HIV RNA, 5.5 (IQR, 5.0-5.8) log copies/mL. Forty-eight participants developed TB-IRIS (incidence rate, 24.7/100 PY), 19 cases in the raltegravir arm and 29 in the efavirenz arm (incidence rate ratio 0.62, 95% confidence interval .35-1.10). Factors associated with TB-IRIS were: CD4 ≤ 100 cells/μL, HIV RNA ≥500 000 copies/mL, and extrapulmonary/disseminated TB. CONCLUSIONS: We did not demonstrate that raltegravir-based ART increased the incidence of TB-IRIS compared with efavirenz-based ART. Low CD4 counts, high HIV RNA, and extrapulmonary/disseminated TB at ART initiation were associated with TB-IRIS.
dc.language.isoENen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.subject.enHIV/AIDS
dc.subject.enIRIS
dc.subject.enAntiretroviral therapy
dc.subject.enRandomized controlled trial
dc.subject.enTuberculosis
dc.title.enIncidence and Predictors of Tuberculosis-associated IRIS in People With HIV Treated for Tuberculosis: Findings From Reflate TB2 Randomized Trial
dc.title.alternativeOpen Forum Infect Disen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/ofid/ofae035en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed38486816en_US
bordeaux.journalOpen Forum Infectious Diseasesen_US
bordeaux.pageofae035en_US
bordeaux.volume11en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.issue3en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamGHIGS_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.identifier.funderIDInstitut de Recherche pour le Développementen_US
hal.identifierhal-04564640
hal.version1
hal.date.transferred2024-04-30T15:19:36Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Open%20Forum%20Infectious%20Diseases&rft.date=2024-03-01&rft.volume=11&rft.issue=3&rft.spage=ofae035&rft.epage=ofae035&rft.eissn=2328-8957&rft.issn=2328-8957&rft.au=COELHO,%20Lara%20E&CHAZALLON,%20Corine&LAUREILLARD,%20Didier&ESCADA,%20Rodrigo&N'TAKPE,%20Jean-Baptiste&rft.genre=article


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