Table 3.
Clinical, antiretroviral treatment (ART), radiological and laboratory characteristics of six children at time of presentation with symptoms or signs suggestive of paradoxical tuberculosis (TB)- associated immune reconstitution inflammatory syndrome (IRIS)
| Case | Time start TB treatment to start ART (days) | Response to TB treatment | Duration of ART at IRIS (days) | Paradoxical reaction | Change between pre-ART and time of IRIS | |
|---|---|---|---|---|---|---|
| CD4% | Viral load | |||||
| 1 | 36 | Radiological improvement Persistence of night sweats |
14 |
Clinical: worsening weight loss Radiological: no abnormal findings |
Not done | Not done |
| 2 | 68 | Weight gain Persistence of cough, night sweats and difficulty breathing |
15 |
Clinical: - New weight loss - New respiratory symptom: haemoptysis Radiological: - New opacification - New reticulonodular infiltrates |
Not done | Not done |
| 3 | 17 | Resolution of symptoms | 60 |
Clinical: - New weight loss Radiological: - Worsening of enlargement of hilar nodes - Worsening of right middle lobe collapse |
+7.7 | +337,000 |
| 4 | 19 | Child continued to lose weight after 2.5 weeks of TB treatment | 14 |
Clinical: - Worsening weight loss - New respiratory symptom (difficulty breathing) Radiological: Chest X-ray not done |
+4.5 | −475,594 |
| 5 | 58 | Radiological improvement | 28 |
Clinical: - New fever - Worsening weight loss - New respiratory symptom (difficulty breathing) Radiological: - Worsening of hilar nodes - Worsening of bronchial compression |
Not done | Not done |
| 6 | 18 | Resolution of symptoms | 32 |
Clinical: - Worsening night sweats - New respiratory symptoms (cough) Radiological: - Stable chest X-ray findings |
Not done | Not done |
| 7 | 15 | Resolution of symptoms | 14 |
Clinical: - New respiratory symptoms (respiratory distress) - New fever Radiological: - New left pleural effusion - New right mid lobe collapse |
Not done | Not done |