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- Occasionally, patients with HIV-related TB may experience a temporary exacerbation of symptoms, signs or radiographic manifestations of TB after beginning anti-TB treatment.
- This paradoxical reaction in HIV infected patients with TB is thought to be a result of immune reconstitution.
- IRIS can occur as a result of TB treatment alone or the initiation of ART with concomitant TB treatment.
- Symptoms and signs may include: high fever, lymphadenopathy, expanding central nervous system lesions and worsening of chest x-ray findings.
- A thorough evaluation is necessary to exclude other causes, particularly TB treatment failure, before diagnosing a paradoxical reaction.
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