A UK-wide retrospective cohort study to analyse the incidence, risk factors and optimal management strategies for paradoxical reaction and immune reconstitution inflammatory syndrome in central nervous system tuberculosis

For more information please look at this introduction-to-TBM-project presentation or the current protocol.

Data collection has now started, REDCap up and running

Site involvement:

King’s College Hospital NHS Foundation Trust – trainee needed

Imperial College Healthcare

University Hospitals Birmingham NHS Trust

University College London/ The Whittington

Royal Free London NHS Foundation Trust

Northern Care Alliance

Manchester Foundation Trust

Bart’s Health NHS Trust

Sheffield Teaching Hospitals NHS Trust

Hull University Teaching Hospitals NHS Trust

University Hospitals Leicester NHS Trust

University hospital Southampton NHS Trust

NHS Greater Glasgow and Clyde

London Northwest University Hospitals NHS Trust

University Hospitals Coventry & Warwickshire NHS Trust

Belfast Health and Social Care Trust

Liverpool University Hospitals NHS Foundation Trust

Contact email: cristina.fernandez2@mft.nhs.uk



To describe the management and outcomes of patients with paradoxical reaction (PR) or immune reconstitution inflammatory syndrome (IRIS) in central nervous system tuberculosis in the UK​


  • Estimate incidence of PR/IRIS​
  • Risk factors​
  • Clinical features​
  • Risks for poor outcome​
  • Compare duration of steroids​
  • Mortality rate​
  • Disability​


Retrospective UK wide cohort study of previous 10 years. Review of patients with central nervous system tuberculosis. Data collected on paradoxical reactions and IRIS.

Please see attached protocol and slide set for more information.