Paradoxical response during anti-tuberculosis treatment in HIV-negative patients with pulmonary tuberculosis
Journal
International Journal of Tuberculosis and Lung Disease
Journal Volume
11
Journal Issue
12
Pages
1290-1295
Date Issued
2007
Author(s)
Abstract
BACKGROUND: Transient worsening of tuberculosis (TB) symptoms and lesions following anti-tuberculosis treatment (paradoxical response [PR]), has been described in human immunodeficiency virus (HIV) infected patients who undergo anti-tuberculosis treatment. The frequency and clinical presentations for PR in HIV-negative patients with pulmonary TB are unknown. OBJECTIVE: To determine the incidence of PR and its associated manifestations in a retrospective study of HIV-negative patients with pulmonary TB. RESULTS: Of 659 TB patients, 16 developed PR, with an incidence of 2.4%. The medium onset time of PR was 26 days. Recurrent fever was the most common clinical manifestation. Compared with 643 patients without PR, patients developing PR had significantly decreased haemoglobin, albumin, body mass index and baseline lymphocyte counts. There was a noticeable increase in the lymphocyte count during paradoxical deterioration in PR subjects than in the control group. Independent factors for developing PR included anaemia, hypoalbuminaemia, lymphopaenia and lymphocyte count increase during PR development. CONCLUSIONS: The clinical manifestations of PR in patients with pulmonary TB were different from those in patients with extra-pulmonary TB. Baseline anaemia, hypoalbuminaemia, lymphopaenia and a greater change in lymphocyte count were independent risk factors for developing PR. ? 2007 The Union.
SDGs
Other Subjects
albumin; corticosteroid; hemoglobin; adult; aged; anemia; article; body mass; central nervous system; confidence interval; controlled study; female; human; hypoalbuminemia; lung tuberculosis; lymphocyte count; lymphocytopenia; major clinical study; male; multivariate analysis; priority journal; recurrent fever; risk factor; Antitubercular Agents; Chi-Square Distribution; Female; HIV Seronegativity; Humans; Incidence; Logistic Models; Male; Middle Aged; Retrospective Studies; Risk Factors; Treatment Outcome; Tuberculosis, Pulmonary
Type
journal article