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Objective:

To determine the burden and impact of immune reconstitution disease (IRD) associated with tuberculosis (TB) among patients initiating antiretroviral treatment (ART) in sub-Saharan Africa.

Design:

Retrospective analysis of a study cohort enrolled over 3 years within a community-based ART service in South Africa.

Methods:

Patients receiving treatment for TB at the time ART was initiated (n= 160) were studied. Cases of TB-associated IRD during the first 4 months of ART were ascertained.

Results:

The median baseline CD4 cell count was 68 cells/μl [interquartile range (IQR), 29–133 cells/μl) and ART was initiated after a median of 105 days (IQR, 61–164 days) from TB diagnosis. Although IRD was diagnosed in just 12%(n= 19) of patients overall, IRD developed in 32%(n= 12) of those who started ART within 2 months of TB diagnosis. Pulmonary involvement was observed in 84%(n= 16) and intra-abdominal …