Incidence and impact of immune reconstitution inflammatory response syndrome associated with tuberculosis regarding the initiation of antiretroviral treatment during antituberculosis therapy in adult patients co-infected with tuberculosis and HIV: A systematic review

Authors

  • Estrin MA MD
  • Basilio La Rosa SE

Keywords:

Inmune Reconstitution Syndrome, Tuberculosis-HIC Coinfection, Antiretroviral Therapy, Tuberculosis and AIDS-Related Opportunistic Infections, Tuberculosis

Abstract

Antiretroviral therapy (ART) is a fundamental key in the fight against HIV, it allows the patient to have a prolonged and high quality life, however in coinfection with opportunistic diseases such as tuberculosis, the initiation of ART can generate a greater risk of immune reconstitution inflammatory syndrome when associated with antituberculosis treatment, generating an exacerbated inflammatory response in tissues rich in Mycobacterium tuberculosis, characterized by the clinical worsening of the patient. The picture ranges from mild and self-limited symptoms to more severe effects and even death.Objectives: This systematic review aims to describe and evaluate the impact, incidence, severity and morbidity of immune reconstitution syndrome (IRRS) on the condition of HIV-positive patients, taking into account the time of ART initiation during antituberculosis treatment. Material and methods: Randomized clinical studies, case-control studies, prospective and retrospective cohorts of the last 11 years, without language limits, obtained from search bases such as PubMed, Cochrane, Embase, performed in adult humans co-infected with mycobacterium tuberculosis and human immunodeficiency virus ( HIV) were evaluated. Results: TO

total of 22 scientific articles were selected and analyzed, 8 of which report that early, immediate and integrated ART of HIV in patients co-infected with TB improved survival despite the higher incidence of TB-SIRI, on the other hand 5 clinical studies affirm that integrated ART generated severe clinical pictures of SIRI-TB and increased mortality, however 5 studies observed that it is more beneficial to initiate ART at any time of anti-tuberculosis treatment, than not to initiate it. Conclusion:our analysis considers it necessary to implement antiretroviral treatment (ART) early in patients coinfected with HIV and TB regardless of the CD4 + cell / mm count, despite the risk of developing another complication such as LRTI associated with TB, taking into account the adequate management of prevention with the corresponding treatment of the opportunistic infection that precedes it, as well as the early diagnosis of LRTI-TB and its consequent treatment, which is not addressed in this review

 

.Keywords: "Immune reconstitution syndrome", "tuberculosis-HIV coinfection", "antiretroviral therapy", "Tuberculosis AND AIDS-Related Opportunistic Infections", "tuberculosis

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References

BIBLIOGRAPHY

- Borand L, Pheng P, Saman M, Leng C, Chea P, Ay SS, et al. Co-infection tuberculosis and HIV - Coordination d'un essai clinique randomisé par l'Institut Pasteur du Cambodge. médecine / sciences. 2013 Oct 1; 29 (10): 908–11. (cited 2020 May 22)

https://www.medecinesciences.org/fr/articles/medsci/abs/2013/10/medsci20132910p908/medsci20132910p908.html

- Abdool Karim SS, Naidoo K, Grobler A, Padayatchi N, Baxter C, Gray AL, et al. Integration of Antiretroviral Therapy with Tuberculosis Treatment. N Engl J Med [Internet]. 2011 Oct 20 [cited 2020 May

; 365 (16): 1492-501. Available from:https://www.nejm.org/doi/full/10.1056/NEJMoa1014181

- Uthman OA, Okwundu C, Gbenga K, Volmink J, Dowdy D, Zumla A, et al. Optimal timing of antiretroviral therapy initiation for HIV-infected adults with newly diagnosed pulmonary tuberculosis: A systematic review and meta-analysis [Internet]. Vol. 163, Annals of Internal Medicine. American College of Physicians; 2015 [cited 2020 May 22]. p. 32–9. Available from:http://annals.org/article.aspx?doi=10.7326/M14-2979

- Gopalan N, Santhanakrishnan RK, Palaniappan AN, Menon PA, Lakshman S, Chandrasekaran P, et al. Daily vs intermittent antituberculosis therapy for pulmonary tuberculosis in patients with HIV a randomized clinical trial. JAMA Intern Med. 2018 Apr 1; 178 (4): 485–93 (cited 2020 May 22)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5885164/

- Mfinanga SG, Kirenga BJ, Chanda DM, Mutayoba B, Mthiyane T, Yimer G, et al. Early versus delayed initiation of highly active antiretroviral therapy for HIV-positive adults with newly diagnosed pulmonary tuberculosis (TB-HAART): A prospective, international, randomized, placebo-controlled trial. Lancet Infect Dis. 2014 Jul 1; 14 (7): 563–71. cited 2020 May 22)https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(14)70733-9/fulltext

- Abdool Karim SS, Naidoo K, Grobler A, Padayatchi N, Baxter C, Gray A, et al.Timing of Initiation of Antiretroviral Drugs during Tuberculosis Therapy. N Engl J Med. 2010; 362 (8): 697–706. cited 2020 Dec 15, Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076221/

- 7. Havlir DV, Kendall MA, Ive P, Kumwenda J, Swindells S, Qasba SS, et al. Timing of antiretroviral therapy for HIV-1 infection and tuberculosis. N Engl J Med. 2011; 365 (16): 1482–91. cited 2020 Dec 16, Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3327101/

- 8- Blanc FX, Sok T, Laureillard D, Borand L, Rekacewicz C, Nerrienet E, et al. Earlier versus later start of antiretroviral therapy in HIV-infected adults with tuberculosis. N Engl J Med. 2011; 365 (16): 1471–81. cited 2020 Dec 20, Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4879711/

- Yang CH, Chen KJ, Tsai JJ, Lin YH, Cheng SH, Wang KF, et al. The impact of HAART initiation timing on HIV-TB co-infected patients, a retrospective cohort study. BMC Infect Dis. 2014; 14: 304. cited 2020 January 15, Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058447/

- Maemun S, Mariana N, Rusli A, Mahkota R, Purnama TB. Early initiation of ARV therapy among TB-HIV patients in Indonesia prolongs survival rates! J Epidemiol Glob Health. 2020; 10 (2): 164–7. cited 2020 January 20, Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310783/

- Luetkemeyer AF, Kendall MA, Nyirenda M, Wu X, Ive P, Benson CA, et al. Tuberculosis immune reconstitution inflammatory syndrome in A5221 STRIDE: Timing, severity, and implications for HIV – TB programs. J Acquir Immune Defic Syndr. 2014; 65 (4): 423–8 cited 2020 January 20, Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3943693/

- Aureillard, Marcy, Madec, Chea, chan D. Paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome after early initiation of antiretroviral therapy in a randomized clinical trial [Internet]. AIDS. 2013 [cited 25 January 2021]. Available from:https://journals.lww.com/aidsonline/Fulltext/2013/10230/Paradoxical_tuberculosis_associated_immune.9.aspx

- Naidoo K, Yende-Zuma N, Padayatchi N, Naidoo K, Jithoo N, Nair G, et al. The immune reconstitution inflammatory syndrome after antiretroviral therapy initiation in patients with tuberculosis: findings from the SAPiT trial. Ann Intern Med. 2012; 157 (5): 313–24,[cited February 1, 2021]. Available from:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3534856/

- Bonnet M, Baudin E, Jani IV, Nunes E, Verhoustraten F, Calmy A, et al. Incidence of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome and impact on patient outcome. PLoS One. 2013; 8 (12): e84585,[cited March 15, 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867516/

- Nagu TJ, Aboud S, Mwiru R, Matee MI, Rao M, Fawzi WW, et al. Tuberculosis associated mortality in a prospective cohort in Sub Saharan Africa: Association with HIV and antiretroviral therapy. Int J Infect Dis. 2017; 56: 39–44,[cited March 18, 2021] https://www.sciencedirect.com/science/article/pii/S1201971217300267

- Bigna JJR, Noubiap JJN, Agbor AA, Plottel CS, Billong SC, Ayong APR, et al. Early mortality during initial treatment of tuberculosis in patients co-infected with HIV at the Yaoundé central hospital, Cameroon: An 8-year retrospective cohort study (2006-2013). PLoS One. 2015; 10 (7): e0132394. [cited March 18, 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516239/

- Kaplan R, Hermans S, Caldwell J, Jennings K, Bekker LG, Wood R. HIV and TB co-infection in the ART era: CD4 count distributions and TB case fatality in Cape Town. BMC Infect Dis. 2018; 18 (1): 356. [cited 20 March 2021]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069570/

- Saraceni V, Durovni B, Cavalcante SC, Cohn S, Pacheco AG, Moulton LH, et al. Survival of HIV patients with tuberculosis started on simultaneous or deferred HAART in the THRio cohort, Rio de Janeiro, Brazil. Braz J Infect Dis. 2014; 18 (5): 491–5. [cited March 21, 2021] https://pubmed.ncbi.nlm.nih.gov/24780362/

- Mutembo S, Mutanga JN, Musokotwane K, Alisheke L, Whalen CC. Antiretroviral therapy improves survival among TB-HIV co-infected patients who have CD4 + T-cell count above 350cells / mm3. BMC Infect Dis. 2016; 16 (1): 572. [cited March 26, 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5067898/

- Nglazi MD, Bekker LG, Wood R, Kaplan R. The impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study. BMC Infect Dis. 2015; 15 (1): 536. [cited March 28, 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653912/

- Muyaya LM, Musanda EM, Tamuzi JL. Human immunodeficiency virus-associated tuberculosis care in Botswana: evidence from a real-world setting. BMC Infect Dis. 2019; 19 (1): 767. [cited March 30, 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6720078/

- Narendran G, Jyotheeswaran K, Senguttuvan T, Vinhaes CL, Santhanakrishnan RK, Manoharan T, et al. Characteristics of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome and its influence on tuberculosis treatment outcomes in persons living with HIV. Int J Infect Dis. 2020; 98: 261–7.[cited April 01, 2021 https://www.ijidonline.com/article/S1201-9712(20)30532-4/fulltext

- Walker; Stek, Wasserman, Wilkinson, Meintjes, N. The tuberculosis-associated immune reconstitution inflammatory syndrome recent advances in clinical and pathogenesis research [Internet]. Current opinion in HIV and AIDS. 2018 [cited April 9, 2021]. Available from:https://journals.lww.com/co-hivandaids/Fulltext/2018/11000/The_tuberculosis_associated_immune_reconstitution.10.aspx

- Crabtree-Ramírez B, Caro-Vega Y, Shepherd BE, Grinsztejn B, Wolff M, Cortes CP, et al. Time to HAART initiation after diagnosis and treatment of opportunistic infections in patients with AIDS in Latin America. PLoS One. 2016; 11 (6): e0153921[cited 9 April 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896474/

- Haddow LJ, Moosa M-YS, Mosam A, Moodley P, Parboosing R, Easterbrook PJ. Incidence, clinical spectrum, risk factors and impact of HIV-associated immune reconstitution inflammatory syndrome in South Africa. PLoS One. 2012; 7 (11): e40623[cited 9 April 2021] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0040623

- Yende-Zuma N, Naidoo K. The effect of timing of initiation of antiretroviral therapy on loss to follow-up in HIV – tuberculosis coinfected patients in South Africa: An open-label, randomized, controlled trial. J Acquir Immune Defic Syndr. 2016; 72 (4): 430–6.[cited April 9, 2021]. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4927384

- Silva CAM, Graham B, Webb K, Ashton LV, Harton M, Luetkemeyer AF, et al. A pilot metabolomics study of tuberculosis immune reconstitution inflammatory syndrome. Int J Infect Dis. 2019; 84: 30–8[cited 9 April 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613934/

- de Sá NBR, Ribeiro-Alves M, da Silva TP, Pilotto JH, Rolla VC, Giacoia-Gripp CBW, et al. Clinical and genetic markers associated with tuberculosis, HIV-1 infection, and TB / HIV-immune reconstitution inflammatory syndrome outcomes. BMC Infect Dis. 2020; 20 (1): 59. [cited 9 April 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971853/

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2021-12-03

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Estrin MA, Basilio La Rosa SE. Incidence and impact of immune reconstitution inflammatory response syndrome associated with tuberculosis regarding the initiation of antiretroviral treatment during antituberculosis therapy in adult patients co-infected with tuberculosis and HIV: A systematic review. Int Jour HS [Internet]. 2021 Dec. 3 [cited 2022 Oct. 3];(1). Available from: https://ijhsc.com/journal/article/view/14

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