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Table 3 Factors associated with prolonged course of paradoxical TB-IRIS (defined as TB-IRIS symptoms lasting longer than 90 days) (n = 181)

From: Prolonged tuberculosis-associated immune reconstitution inflammatory syndrome: characteristics and risk factors

  TB-IRIS symptoms > 90 days (n = 73) (40.3 %) TB-IRIS symptoms ≤ 90 days (n = 108) (59.7 %) p-value for comparison
Female gender 50 (68.5) 66 (61.1)  
Male gender 23 (31.5) 42 (38.9) 0.39
Age (years) 31 (26, 35) 31 (27, 37) 0.32
WHO stage (n = 181)
 3 22 (30.1) 40 (37)  
 4 51 (69.9) 68 (63) 0.42
CD4 count prior to ART (cells/μl) (n = 170) 57.5 (29, 91.2) 52 (29.2, 101) 0.77
CD4 count at TB-IRIS (cells/μl) (n = 89) 117 (71.7, 193.5) 116 (69, 262.5) 0.77
Previous TB (n = 180) 15 (20.6) 30 (28) 0.34
Drug-resistant TB (n = 181)a 10 (13.7) 4 (3.7) 0.02
Initial TB diagnosis with extra-pulmonary features (n = 181) 49 (67.1) 66 (61.1) 0.5
Initial TB diagnosis with lymph node involvement (n = 178) 25 (34.2) 19 (18.1) 0.02
Duration from TB treatment to ART (days)(n = 181) 58 (33, 84) 56 (31, 79.5) 0.8
Duration from ART to TB-IRIS onset (days) (n = 181) 13 (7, 23) 14 (7, 17) 0.51
Hospitalised at time of TB-IRIS diagnosis (n = 176) 25 (34.2) 58 (56.3) 0.01
TB-IRIS lymph node involvement (n = 181) 40 (54.8) 31 (28.7) < 0.0001
TB-IRIS pulmonary involvement (n = 181) 23 (31.5) 49 (45.4) 0.07
TB-IRIS meningitis (n = 181) 1 (1.4) 5 (4.7) 0.42
TB-IRIS abdominal involvement (n = 181) 59 (80.8) 81 (75) 0.37
TB-IRIS multisystem involvement (n = 181) 64 (87.7) 86 (79.6) 0.17
Pulse rate (n = 120) 121 (105, 133) 119 (108, 130) 0.96
C-reactive protein (mg/l) (n = 172) 111 (74, 157.3) 95.5 (46.6, 165.7) 0.14
Haemoglobin (g/dl) (n = 113) 9.0 (8.0, 10.1) 9.1 (8.0, 10.6) 0.62
White cell count (×109/l) (n = 109) 5.9 (4.2, 7.2) 6.0 (4.4, 8.6) 0.33
ALT (IU/l) (n = 157) 40 (25, 60) 35 (22, 48) 0.13
Alkaline phosphatase (IU/l) (n = 147) 164 (114, 261) 164 (95, 278) 0.46
Corticosteroid treatment for TB-IRIS 48 (65.8 %) 63 (58.3 %) 0.35
  1. Medians (interquartile range) or number (%) are shown. Categorical variables were compared using Fisher’s exact test and continuous variables using Wilcoxon rank sum test. Pulse rate and laboratory values refer to the value obtained when the patient was first assessed with TB-IRIS symptoms, unless otherwise stated. Numbers in brackets after the variable name refer to the number of patients for whom that variable was available
  2. Abbreviations: ALT alanine transferase, ART antiretroviral therapy, IRIS immune reconstitution inflammatory syndrome, TB tuberculosis, WHO World Health Organisation
  3. aAmong 14 patients with drug resistant TB: four had rifampicin mono-resistance, two had isoniazid mono-resistance and eight had resistance to rifampicin and isoniazid