(for use in resource-limited settings) Patient is not receiving treatment for tuberculosis when ART is initiated and then presents with active tuberculosis within 3 months of starting ART AND one of the following criteria must be met: Heightened intensity of clinical manifestations, particularly if there is evidence of a marked inflammatory component to the presentation. Examples include tuberculosis lymphadenitis or tuberculosis abscesses with prominent acute inflammatory features, presentation with pulmonary tuberculosis that is complicated by respiratory failure due to adult respiratory distress syndrome, and those who present with a marked systemic inflammatory syndrome related to tuberculosis. See example in figure 2. Once established on tuberculosis treatment, a clinical course that is complicated by a paradoxical reaction.

OTHER DEFINITIONS