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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 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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Results From 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 Median CD4 counts of patients co-infected with TB-HIV on antiretroviral therapy
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Treatment outcomes Mortality: 6 (10%) patients with TB-IRIS died vs 18 (15%) without TB-IRIS OR mortality = 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 OR loss2fu = 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
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