Immune reconstitution inflammatory syndrome: a report of TB-IRIS after switching from efavirenz to dolutegravir. (April 2021)

• Record Type: Journal Article
• Authors: Zimba, Stanley; Mbewe, Nyuma; Chishimba, Lorraine; Chomba, Mashina; Saylor, Deanna
• Is Part Of: Tropical doctor. Volume 51:Number 2(2021)
• Page Start: 216
• Page End: 218
• Publication Date: 2021-04
• Subjects: Tuberculosis -- dolutegravir -- immune reconstitution inflammatory syndrome -- HIV; Tropical medicine -- Periodicals; Medical care -- Developing countries -- Periodicals; Developing Countries -- Periodicals; Tropical Medicine -- Periodicals; Tropische geneeskunde; 616.9883
• DOI: 10.1177/0049475520953704
• Languages: English
• ISSNs: 0049-4755

Abstract

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.