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PredART trial: prednisone reduces risk of TB-IRIS in HIV-infected patients by 30%

16 February 2017

Results of the EDCTP-funded PredART clinical trial, led by Dr Graeme Meintjes, University of Cape Town, South Africa were presented at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) (Abstract #81LB) on 15 February 2017. The trial showed that prednisone, a cheap drug readily accessible in low- and middle-income countries, reduces the risk of developing TB-IRIS by 30% in patients on tuberculosis (TB) treatment starting antiretroviral therapy (ART). The trial also showed that prednisone is safe when used in patients with advanced HIV.

The findings of the PredART trial provide the first evidence of an effective strategy to reduce the risk of this very common complication of starting ART in HIV-infected patients undergoing TB treatment.

Read: Abstract ‘Randomized controlled trial of prednisone for prevention of paradoxical TB-IRIS’ presented a CROI 2017 on 15 February 2017.

Watch: EDCTP video on the PredART trial. It was filmed in a HIV-TB clinic in Khayelitsha, a community of 500,000 people on the outskirts of Cape Town, South Africa with very high rates of TB and HIV infections.

 

About the PredART trial

The PredART trial aimed to develop a treatment intervention to address the TB-associated immune reconstitution inflammatory syndrome (TB-IRIS) complication in HIV-TB co-infected patients. When patients have both HIV and TB infections, treatments need to be combined. One of the most common complications in those patients is TB-IRIS. When HIV treatment with antiretrovirals leads to a rapid reconstitution of the immune system, a strong inflammatory response to the tuberculosis and other infections may result. TB-IRIS can be life threatening or at the very least undermine patients’ confidence in their treatment. Currently there is no preventative strategy for TB-IRIS.

The trial was funded by EDCTP, with cofunding from the South African National Department of Science and Technology and the Wellcome Trust.