6. Additional summary 2: early versus deferred ART.
| Early ART compared with deferred ART for PDH in HIV | ||||||
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Patient or population: adults with HIV and progressive disseminated histoplasmosis Settings: endemic areas Intervention: early ART (< 14 days) Comparison: late ART (> 14 days) | ||||||
| Outcomes | Illustrative risks | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| IRIS | 1/3 participantsa | 1/7 participantsa |
RR 0.43 (0.04 to 4.82) |
10 (1 study) | ⊕⊝⊝⊝ Very lowb,c |
We do not know if early ART increases the risk of IRIS in people with HIV and PDH. |
| ART: antiretroviral therapy; IRIS: immune reconstitution inflammatory syndrome; PDH: progressive disseminated histoplasmosis; RCT: randomized controlled trial; RR: risk ratio. | ||||||
a1/3 people with histoplasmosis in deferred ART arm developed histoplasma IRIS (day 47). 1/7 people with histoplasmosis in early ART arm developed hepatitis C IRIS (day 14). bDowngraded two levels for serious imprecision. The CI was wide. cDowngraded one level for serious indirectness. The trial only included 10 participants with histoplasmosis and the case definitions were not stated.