Adalimumab for Corticosteroid and Infliximab-Resistant Immune Reconstitution Inflammatory Syndrome in the Setting of TB/HIV Coinfection

Nilar Lwin; Michael Boyle; Joshua S Davis

doi:10.1093/ofid/ofy027

Adalimumab for Corticosteroid and Infliximab-Resistant Immune Reconstitution Inflammatory Syndrome in the Setting of TB/HIV Coinfection

Open Forum Infect Dis. 2018 Jan 30;5(2):ofy027. doi: 10.1093/ofid/ofy027. eCollection 2018 Feb.

Authors

Nilar Lwin¹, Michael Boyle^{1

2}, Joshua S Davis^{1

2

3}

Affiliations

¹ Department of Immunology and Infectious Diseases, John Hunter Hospital, Newcastle, NSW, Australia.
² School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
³ Global and Tropical Health Division, Menzies School of Health Research, Darwin, NT, Australia.

Abstract

Corticosteroids are the mainstay of therapy for immune reconstitution inflammatory syndrome (IRIS). However, little is known about how to treat IRIS unresponsive to steroids. We report a patient with HIV-TB coinfection who was unresponsive to first prednisolone and then infliximab but whose IRIS resolved with adalimumab.

Keywords: HIV; adalimumab; immune reconstitution; steroid; tuberculosis.