Immune reconstitution inflammatory syndrome: a report of TB-IRIS after switching from efavirenz to dolutegravir.
Stanley ZimbaNyuma MbeweLorraine ChishimbaMashina ChombaDeanna SaylorPublished in: Tropical doctor (2020)
In 2016, the World Health Organization adopted dolutegravir (DTG)-based antiretroviral therapy as an alternative first-line treatment of HIV after many clinical trials showed that it was more effective, better tolerated and more protective than efavirenz and boosted protease inhibitors against discontinuation of treatment from adverse drug reactions. However, there was concern that DTG would lead to increased rates of immune reconstitution inflammatory syndrome (IRIS), especially in the setting of late presentation to care. Three cases at the University Teaching Hospital in Lusaka, Zambia highlight this concern, especially in persons living with HIV (PLWH), resulting in tuberculosis (TB) co-infection.
Keyphrases
- antiretroviral therapy
- adverse drug
- hiv infected
- hiv aids
- hiv infected patients
- hiv positive
- human immunodeficiency virus
- mycobacterium tuberculosis
- clinical trial
- case report
- oxidative stress
- healthcare
- palliative care
- emergency department
- electronic health record
- pulmonary tuberculosis
- south africa
- pain management
- phase ii
- open label
- affordable care act
- combination therapy
- health insurance
- smoking cessation