Prednisone for Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome

In resource-limited settings, many people starting antiretroviral therapy (ART) are already being treated for active tuberculosis (TB), and this sequence of therapies can lead to TB-associated immune reconstitution inflammatory syndrome (TB-IRIS). Although this condition is rarely fatal, it causes substantial morbidity, and little is known about the best way to manage it.

Investigators recently conducted a randomized, double-blind, placebo-controlled trial in South Africa to determine whether a short course of oral prednisone might be of value in patients with TB-IRIS. Patients were considered for the study if they were receiving TB treatment, had recently initiated ART, were experiencing new or recurrent TB symptoms, and had at least one of…