DOI: http://dx.doi.org/10.18203/2349-3933.ijam20214524

A prospective study of spectrum of pulmonary tuberculosis in HIV sero positive patients

Ganedi Seshu Kumari

Abstract


Background: Tuberculosis is the leading cause of death in India contributing to 30% of total global burden. Approximately 0.5 million people dies of TB annually and 5% of the incident TB cases in India have HIV. So it is important to understand the effect of tuberculosis and HIV on each other. HIV epidemics have leads to increased number of tuberculosis cases with various presentations.

Methods: It is an observational cross-sectional study of patients with HIV positive and pulmonary TB. Patients were investigated for HIV positivity by HIV coomb's test, if positive confirmed by capillaries and tridot method. Some patients, who are diagnosed as having pulmonary Koch, are sent for HIV testing. CD4 cells count as tested in all patients with HIV positive and severity of pulmonary TB and relation with CD count is studied in all patients.

Results: In chest x-ray of patients we have observed that upper zone infiltration was found in 10 (16.67%) patients, mid and lower zone infiltration was found in 19 (31.67%) patients, bilateral infiltration and miliary tuberculosis was found in 22 (36.67%). We have found that 9 (15%) patients were presented with fibro cavitary lesion.

Conclusions: From present study we can conclude that tuberculosis and HIV is common between 3rd and 5th decade of life with male predominance. It was more common in daily labourer and BMI was 18.22±3.21 kg/m2. Fever, weight loss and cough was most common presentation and present in more than 90% patients pallor and lymphadenopathy was common finding and present in more than 50% patients.


Keywords


Pulmonary tuberculosis, Spectrum, HIV, CD4 counts

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References


HIV/AIDS world health organization. Available at: https://www.who.int/news-room/fact-sheets/de tail/hiv-aids. Accessed on 10 August 2021.

Global health sector strategy on HIV. Available at: https://apps.who.int › WHO-HIV-2016.05-eng.pdf. Accessed on 10 August 2021.

HIV-Associated Tuberculosis, Achievements in 2018. Available at: https://www.who.int/tb/areas-of-work/tb-hiv/tbhiv_factsheet.pdf?ua=1. Accessed on 10th august 2021.

Dravid A, Natarajan K, Medisetty M. Incidence of tuberculosis among HIV infected individuals on long term antiretroviral therapy in private healthcare sector in Pune, Western India. BMC Infect Dis. 2019;19:714.

Jaryal A, Raina R, Sarkar M, Sharma A. Manifestations of tuberculosis in HIV/AIDS patients and its relationship with CD4 count. Lung India. 2011;28(4):263-6.

Takhar RP, Mirdha K, Purohit G, Maan L, Bainara MK. Impact of HIV Co-Infection on Clinical Presentation in Patients with TB and Correlation of the Findings with Level of Immune Suppression. Tanaffos. 2018;17(3):188-97.

Sharma SK, Soneja M, Prasad KT, Ranjan S. Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India. Indian J Med Res. 2014;139(1):154-60.

Zumla A, Malon P, Henderson J. Impact of HIV infection on tuberculosis Postgraduate Medical Journal. 2000;76:259-68.

Havlir DV, Barnes PE. Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med. 1999;340:367-73.

Manjareeka M, Nanda S. Prevalence of HIV infection among tuberculosis patients in Eastern India. J Infect Public Health. 2013;6(5):358-62.

Holmberg V, Soini H, Kivelä P. Epidemiology and outcome of HIV patients in Finland co-infected with tuberculosis 1998–2015. BMC Infect Dis. 2019;19:264.

Zhang X, Andersen AB, Lillebaek T, Kamper-Jørgensen Z, Thomsen VØ, Ladefoged K et al. Effect of sex, age, and race on the clinical presentation of tuberculosis: a 15-year population-based study. Am J Trop Med Hyg. 2011;85(2):285-90.

Bhargava A, Chatterjee M, Jain Y, Chatterjee B, Kataria A, Bhargava M et al. Nutritional status of adult patients with pulmonary tuberculosis in rural central India and its association with mortality. PLoS One. 2013;8(10):e77979.

Ngowi BJ, Mfinanga SG, Bruun JN. Pulmonary tuberculosis among people living with HIV/AIDS attending care and treatment in rural northern Tanzania. BMC Public Health. 2008;8:341.

Antwal M, Gurjar R, Chidrawar S, Pawar J, Gaikwad S, Panchal N et al. Clinical profile of HIV infected patients attending a HIV referral clinic in Pune, India. Indian J Med Res. 2014;140(2):271-7.

Padyana M, Bhat RV, Dinesha M, Nawaz A. HIV-Tuberculosis: A Study of Chest X-Ray Patterns in Relation to CD4 Count. N Am J Med Sci. 2012;4(5):221-5.

Rajasekaran S, Mahilmaran A, Annadurai S, Kumar S, Raja K. Manifestation of tuberculosis in patients with human immunodeficiency virus: a large Indian study. Ann Thorac Med. 2007;2(2):58-60.

Jones BE, Young SM, Antoniskis D, Davidson PT, Kramer F, Barnes PF. Relationship of the manifestations of tuberculosis to CD4 cell counts in patients with human immunodeficiency virus infection. Am Rev Respir Dis. 1993;148(5):1292-7.