Incidences, clinical features and risk factors for tuberculosis-associated immune reconstitution inflammatory syndrome: retrospective analysis of 305 patients

刘敏; 谭顺; 李奇穗; 唐德谊; 陈耀凯

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Incidences, clinical features and risk factors for tuberculosis-associated immune reconstitution inflammatory syndrome: retrospective analysis of 305 patients

更新时间：2026-01-09

- Incidences, clinical features and risk factors for tuberculosis-associated immune reconstitution inflammatory syndrome: retrospective analysis of 305 patients
- Journal of Army Medical University Vol. 38, Issue 17, Pages: 1954-1958(2016)
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  CLC： R512.91;R521;R593
- Published：2016
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刘敏,谭顺,李奇穗,唐德谊,陈耀凯.结核相关性免疫重建炎性综合征发生率、临床特征及危险因素的回顾性分析[J].陆军军医大学学报(原第三军医大学学报),2016,38(17):1954-1958.

　Liu Min,Tan Shun,Li Qisui,Tang Deyi,Chen Yaokai.Incidences, clinical features and risk factors for tuberculosis-associated immune reconstitution inflammatory syndrome: retrospective analysis of 305 patients[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(17):1954-1958.
刘敏,谭顺,李奇穗,唐德谊,陈耀凯.结核相关性免疫重建炎性综合征发生率、临床特征及危险因素的回顾性分析[J].陆军军医大学学报(原第三军医大学学报),2016,38(17):1954-1958. DOI：

　Liu Min,Tan Shun,Li Qisui,Tang Deyi,Chen Yaokai.Incidences, clinical features and risk factors for tuberculosis-associated immune reconstitution inflammatory syndrome: retrospective analysis of 305 patients[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(17):1954-1958. DOI：

摘要

目的分析结核相关性免疫重建炎性综合征（TB-associated immune reconstitution inflammatory syndrome

TB-IRIS）的发生率、临床特征、危险因素及预后，以提高对该临床综合征的认识，减少其不良影响。方法回顾性分析HIV/TB双重感染者临床资料，计算TB-IRIS发生率，并对比分析TB-IRIS的发生与年龄、性别、入院时CD4+细胞计数、入院时HIV RNA定量及结核病类型等指标是否存在相关性。结果 HIV/TB病例共305例，其中13.1%（40例）发生TB-IRIS；发生TB-IRIS者治疗前CD4+细胞计数显著低于未发生TB-IRIS者，发生TB-IRIS者平均年龄低于未发生TB-IRIS者（P0.05）；抗逆转录病毒（ART）治疗6个月内发生TB-IRIS者CD4+细胞增长值高于未发生TB-IRIS者，但1年后两组患者CD4+细胞计数增长值相近；40例TB-IRIS病例均有发热，体温≥39.0 ℃者85.0%；TB-IRIS治愈率为95.0%，病死率为5.0%。结论 TB-IRIS多发生于ART治疗后1个月之内；治疗前CD4+细胞计数≤50个/μL及年龄≤60岁是TB-IRIS发生的危险因素；TB-IRIS预后良好。

Abstract

Objective To analyze the incidence

clinical features

risk factors and prognosis of tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) in order to promote the awareness of the syndrome. Methods Clinical data of 305 co-infected patients of human immunodeficiency virus (HIV)/tuberculosis (TB) were collected. The occurrence of TB-IRIS was calculated. The correlations of TB-IRIS with age

sex

CD4+ cell counts

HIV RNA levels and the severity of tuberculosis were respectively analyzed. Results The incidence of TB-IRIS was 13.1% (40/305) in the subjects. The patients with TB-IRIS had larger CD4+ cell count and younger age when compared with those without TB-IRIS at admittance (P0.05). For the patients who was found having TB-IRIS within 6 months after artiretroviral therapy (ART)

the increase of their CD4+ cell counts were larger than those without TB-IRIS

but the increase was similar in 1 year after ART. All 40 TB-IRIS patients had fever

and 85.0% of them had body temperature higher than 39 Celsius degrees. Thirty-eight patients (95.0%) were recovered from TB-IRIS

but the other 2 (5.0%) died from opportunistic infections. Conclusion TB-IRIS mostly occurs in the first month after ART but has a relatively optimistic prognosis. Lower CD4+ cell count (≤50 cells/μL) before ART and younger age (≤60 years) are risk factors for TB-IRIS.

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