Table 2 Characteristics, treatment and clinical course for six patients in whom TB-IRIS duration was longer than 1Â year
|  | Age at TB-IRIS onset (years) | Pre-ART CD4 count (cells/μl) | Initial TB diagnosis | Initial IRIS features | Duration of TB-IRIS (days) | Duration of steroid treatment (days) | Features that persisted > 1 year | Comments |
|---|---|---|---|---|---|---|---|---|
1 | 35 | 78 | Extra-pulmonary TB (nodal) | Nodal | 746 (IRIS ongoing at last visit) | 70 | Cerebellar tuberculomas/abscesses | The initial TB-IRIS episode involved lymph nodes and resolved on prednisone then patient re-presented several months later with new neurological manifestations and multiple rim-enhancing lesions in the cerebellum. Brain abscess resection tissue cultured drug-susceptible MTB. Experienced recurrence of TB-IRIS symptoms on tapering of steroids and required re-escalation of steroid doses. |
2 | 34 | 160 | Extra-pulmonary TB (nodal and miliary) | Nodal | 824 (IRIS ongoing at last visit) | 98 | Supraclavicular nodes and large cold abscess | Experienced recurrence of TB-IRIS symptoms on tapering of steroids and required re-escalation of steroid doses. |
3 | 56 | 65 | Extra-pulmonary TB (miliary) | Nodal | 426 | 0 | Cervical and submandibular nodes | - |
4 | 26 | 44 | Extra-pulmonary TB (abdominal) | Abdominal | 462 | 168 | Axillary and cervical nodes, abdominal wall cold abscesses, mastitis | Patient found to have rifampicin mono-resistant MTB (urine culture sent at diagnosis) at TB-IRIS diagnosis. She was commenced on prednisone after commencement of appropriate treatment for rifampicin mono-resistant TB. Experienced recurrence of TB-IRIS symptoms on tapering of steroids and required re-escalation of steroid doses. |
5 | 36 | 39 | Extra-pulmonary TB (nodal and abdominal) | Nodal | 1362 | 308 | Multiple suppurating cervical nodes, psoas abscesses and abdominal pus collections | Experienced recurrence of TB-IRIS symptoms on tapering of steroids and required re-escalation of steroid doses. Patient still had residual left iliac fossa mass on abdominal imaging at TB-IRIS resolution that was decreasing in size and was asymptomatic. |
6 | 39 | 80 | Extra-pulmonary TB (nodal) | Nodal | 519 | 137 | Lymph nodes and cold abscesses | - |