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Tuberculosis remains a tremendous global health burden. Tuberculous pericarditis is a common complication of this disease in sub-Saharan Africa and parts of Asia, particularly among HIV-coinfected individuals. Despite antimicrobial therapy, morbidity and mortality are high.
To explore the potential role of adjunctive therapies that involve host immune response, researchers conducted a factorial-design trial involving adults with presumed tuberculous pericarditis at 19 hospitals in eight African countries. Overall, 1400 patients were randomized to receive placebo or prednisolone, as well as either placebo or immunotherapy with heat-killed Mycobacterium indicus pranii. Two thirds of enrollees were HIV infected, and 90% had moderate to large pe…