Table 4.
Classification of possible tuberculosis (TB) associated immune reconstitution inflammatory syndrome (IRIS) event by expert panel and the consensus definition developed by the International Network for the Study of HIV-associated IRIS (INSHI)
| Case | EXPERT PANEL | INSHI CRITERIA |
|||||
|---|---|---|---|---|---|---|---|
| Meets antecedent criteria | Meets clinical criteria (≥1 major or ≥2 minor) | Alternative explanation | Resolution without change in treatment for TB or HIV | Classification | |||
| TB diagnosis according to guidelines | Condition stabilizes or improves on TB treatment | ||||||
| 1 | Not TB-IRIS | Yes | Yes Radiological improvement but persistence of night sweats |
No | No | Yes | Not TB-IRIS |
| 2 | Paradoxical TB-IRIS | Yes | Yes Weight gain, other symptoms stabilized |
Yes | No | Yes | Paradoxical TB-IRIS |
| 3 |
Not TB-IRIS Increase in VL suggests non-adherence to ART |
Yes | Yes | Yes | No | Yes | Paradoxical TB-IRIS |
| 4 | Not TB-IRIS | Yes | No Continued weight loss after 2.5 weeks of TB treatment |
Yes | Yes Mother stopped TB treatment at start antiretroviral treatment |
Yes | Not TB-IRIS |
| 5 | Paradoxical TB-IRIS | Yes | Yes | Yes | No | Yes | Paradoxical TB-IRIS |
| 6 |
Not TB-IRIS Pneumonia most likely diagnosis; cannot exclude paradoxical TB-IRIS |
Yes | Yes | Yes | Resolution without change in antiretroviral or TB treatment regimen | Yes | Paradoxical TB-IRIS |
| 7 |
Not TB-IRIS Pneumonia most likely diagnosis; cannot exclude paradoxical TB-IRIS |
Yes | Yes | Yes | Resolution without change in antiretroviral or TB treatment regimen | Yes | Paradoxical TB-IRIS |