Immune Reconstitution Tuberculosis in HIV Patients after Antiretroviral Therapy

ABSTRACT

Free antiretroviral therapy is being given to eligible people living with HIV in India since April 2004. Govt. Hospital of Thoracic Medicine, Tambaram Sanatorium, Chennai is one of the largest centers managing HIV/AIDS patients with antiretroviral therapy in India.This study finds out the incidence of tuberculosis as the manifestation of ‘Immune Reconstitution Syndrome (IRS)’ after the initiation of Antiretroviral therapy in patients with HIV/AIDS. All the patients, placed under ART, were followed up for the occurrence of tuberculosis from April 2004 to December 2005 at GHTM, Tambaram Sanatorium, Chennai. 2330 HIV patients were initiated antiretroviral therapy till December 2005 and of whom 1409 (61%) were already treated for tuberculosis. 302 (12.9%) had IRS and 81 (3.5%) had tuberculosis, as the component of IRS. Occurrence of tuberculosis as IRS manifestation is significantly high after antiretroviral therapy. This results in starting or restarting anti tuberculosis treatment with the changed or modified antiretroviral therapy in a large number of patients, escalating treatment cost.