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26 Access to ART is improving worldwide, but because many patients still commence ART with low CD4 counts, IRIS remains a common complication.
7, 8 HIV-associated immune reconstitution inflammatory syndrome (IRIS) has emerged as an important early complication of ART initiation, associated with considerable morbidity and mortality, particularly in patients who commence ART with advanced immunosuppression.
It seemed possible that symptom severity would influence subjects' decision to commence ART.
This will detect those that will commence ART due to renal impairment.
10/24 (41%) were recommended to commence ART due to age or other factors.
Adults who were about to commence ART were recruited for this study after obtaining written informed consent.
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Twelve patients died prior to commencing ART, 200 patients started ART, 172 were followed-up to 48 weeks and 132 to at least 64 weeks.
Extra-pulmonary (EPTB /PTB was significantly higher among patients who commenced ART before compared with those who started ART after MDR-TB treatment initiation (20.7 % vs. 13.9 %, (p = 0.007)).
Two patients (7 and 11) had detectable CMV DNA prior to commencing ART, so antigen load prior to ART may drive production of CMV antibody when ART commences.
However, once HIV infected patients have commenced ART in resource limited settings, the benefits of continued CTX prophylaxis are not known.
Inpatients not commencing ART while in hospital were referred to the outpatient programme upon discharge.
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