Incidence of TB-IRIS Among HIV+ve Patients in North India: A Prospective Study

Abstract

IntroductionTB-IRIS is an important cause of morbidity and mortality in patients with HIV disease who are initiated on ART. This prospective study investigates the incidence and associated risk factors of TB-IRIS among HIV+ve patients initiating ART in North India.MethodsThe study included 400 ART-naive HIV+ve patients with or without pre-existing TB. Participants underwent clinical evaluation, laboratory tests, and imaging at baseline, followed by monthly follow-ups to monitor the development of TB-IRIS over a year.ResultsThe study identified a TB-IRIS incidence of 9.5% among the cohort. The mean duration for TB-IRIS onset was 2.87 months, with a higher prevalence noted in patients within the first two months of ART initiation. Key baseline factors associated with TB-IRIS included low CD4 count, Hb levels, high total leukocyte count, serum creatinine, and TC levels. Notably, the CD4 count, and inflammatory markers such as CRP and ESR significantly increased from baseline to the development of TB-IRIS. The study also highlighted a significantly higher mortality rate among TB-IRIS patients compared to those without IRIS.ConclusionThe findings underscore the necessity for vigilant monitoring and early detection of TB-IRIS in HIV+ve patients undergoing ART in TB-endemic regions to mitigate morbidity and mortality.