alexa Early Versus Late Antiretroviral Therapy In Decreasing The Incidence Of Paradoxical Immune Reconstitution Inflammatory Syndrome Among Adolescent And Adult Patients With HIV-tuberculosis: A Meta-analysis
ISSN: 2332-0877

Journal of Infectious Diseases & Therapy
Open Access

OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Share This Page

Additional Info

Loading Please wait..

4th International Congress on Infectious Diseases
May 11-12, 2017 Barcelona, Spain

Christoper John N Tibayan and Emmanuel Surposa
Osmak Hospital, Philippines
Posters & Accepted Abstracts: J Infect Dis Ther
DOI: 10.4172/2332-0877-C1-024
Research Question: Among patients with HIV-tuberculosis, how effective is late initiation of antiretroviral therapy compared to early initiation of antiretroviral therapy following anti Koch’s regimen in decreasing the incidence of paradoxical immune reconstitution inflammatory syndrome (IRIS)? Background: IRIS is defined as a worsening of existing lesions or presentation of new lesions during treatment of an opportunistic infection most frequently seen among patients on anti-Koch’s regimen. Randomized controlled trials showed that delaying initiation of antiretroviral treatment for about four weeks or more after starting anti Koch’s regimen showed a decreased incidence of IRIS among HIV patients with concomitant tuberculosis. Aim: This meta-analysis aims to compare the effects of late initiation of antiretroviral therapy with early initiation of antiretroviral therapy following anti Koch’s regimen among patients with HIV-tuberculosis co-infection with primary outcome measured as paradoxical TB-IRIS. Materials & Methods: Online databases were used to search for randomized controlled trials published from January 2010 to June 2015. Review Manager 5.3 was used to compute for the total odds ratios for both interventions using a fixed-effects model with 95% confidence interval. Results: Seven randomized controlled trials were included. Late initiation of antiretroviral therapy (>4 weeks following initiation of anti-Koch’s regimen) among patients with HIV-tuberculosis was associated with lower odds of developing paradoxical TB-IRIS (OR: 0.54 at 95% Confidence Interval, p <0.00001). Conclusion: Late initiation of antiretroviral therapy following standard anti Koch’s regimen is associated with lower odds of developing paradoxical TB-IRIS, however has been associated with increase in overall mortality as compared with mortality associated with paradoxical IRIS. Baseline CD4+ cell counts <50/ul has been identified as an independent risk factor for both mortality and development of paradoxical TB-IRIS. A larger study population and elimination of probable confounding variables are recommended in future researches.

Email: [email protected]

image PDF   |   image HTML

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version