IRIS associated with tuberculosis of CNS in HIV and non-HIV infected patients: how long do we need to use steroids

Abstract

Background Although the immune recovery associated with highly active antiretroviral therapy (HAART) in HIV infection has important clinical benefits, this restoration of immunity may result in deterioration, when HAART is initiated in patients with tuberculosis (TB). The immune reconstitution inflammatory syndrome (IRIS) has also been reported in non-HIV persons following anti-TB treatment (ATT). The incidence of IRIS in case-control studies on HIV and non-HIV-infected patients, has been found to be 28-36% and 7-10%, respectively, depending on background tuberculosis prevalence rates. We report two cases illustrating IRIS in treated CNS TB, one in a patient diagnosed with HIV stage C3 and the second in a patient with immunosuppression due to anti-tumor necrosis factor alpha treatment.