Title: HIV and Tuberculosis: the impact goes beyond those infected with HIV/AIDS
Authors: Sanjay Kumar Garg, Shivraj Meena, Shivcharan Jelia, S.R Meena
DOI: http://dx.doi.org/10.18535/jmscr/v4i4.51
Abstract
Background & objectives: Tuberculosis is said to be one of the commonest opportunistic infection in patients with HIV/ AIDS. In this study the clinical profile of tuberculosis in patient with HIV infection /AIDS and to study the pulmonary and extra pulmonary tuberculosis involvement and clinical profile in HIV infection/AIDS subjects.
Methods: HIV sero-positive patients with symptoms suggestive of pulmonary and extra pulmonary tuberculosis, attending the Outpatient Departments and indoor at Department of Medicine, Govt. Medical College, Kota.
Results: fever (97.1%), weight loss (85.7%) cough (80%), pallor (68.5%) mouth ulcer (41.4%) and lymphadenopathy (33%). Incidence of both Pulmonary and extra pulmonary tuberculosis were almost same (45.71%).Among extra pulmonary tuberculosis, abdominal TB was (18.57%). Infiltrative lesions were (54.28%) on chest x-ray. Sputum positivity was seen only in 31.25% of patients. Mean CD4 counts was 133.95+141.89 cells/ µl. Most of the patients (78.57%) had CD4 counts <200 cells /µl. 77% of sputum negative TB, 88.32% of extra pulmonary TB had CD4 cell count <200 cells/ µl. and 100% of disseminated TB had CD4 cell count <50 cells/ µl.90% Sputum positive cases were seen with CD4 cell count >50 cells/µl.
Conclusion- most common manifestation of TB in HIV infected patients were sputum negative pulmonary TB. A high proportion of cases with extra pulmonary TB were also found. There is an urgent need to strengthen the information, education and expand the ART services to meet the requirement of early testing and treatment initiation in patients co-infected with HIV-TB.
Keywards- HIV/TB, AIDS, Tuberculosis, Extrapulmonary TB.
References
1. Girardi, E., Goletti, D., Antonucci, G., & Ippolito, G. (2001). Tuberculosis and HIV: A deadly interaction. J Biol Regul Homeost Agents, 15(3), 218-23.
2. Harries AD and Maher D. TBIHIV - A Clinical Manual World Health Organization Publication (Geneva) WHO/TB/96.200.
3. World Health Organization. 5. Global tuberculosis control: WHO report. 2011. Geneva: WHO; 2011. p. 9-27.
4. Vijay 6. S, Kumar P, Chauhan LS, Rao SV, Vaidyanathan P. Treatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control programme in a district of South India. PLoS One 2011; 6 : e21008.
5. Swaminathan7. S, Deivanayagam CN, Rajasekaran S, Venkatesan P, Padmapriyadarsini C, Menon PA, et al. Long term follow up of HIV-infected patients with tuberculosis treated with 6-month intermittent short course chemotherapy. Natl Med J India 2008; 21 : 3-8.
6. Tripathy S8. , Anand A, Inamdar V, Manoj MM, Khillare KM, Datye AS, et al. Clinical response of newly diagnosed HIV seropositive & seronegative pulmonary tuberculosis patients with the RNTCP Short Course regimen in Pune, India. Indian J Med Res 2011; 133: 521-8.
7. National AIDS Control Organization (NACO). Department of AIDS Control, Ministry of Health and Family Welfare, Government of India, New Delhi, Annual Report 2010-11. New Delhi: NACO; 2011.
8. National AIDS Control Organization and Central TB Division.2. National Framework for Joint HIV/TB Collaborative Activities. October 2009. New Delhi: National AIDS Control Organization and Central TB Division, Ministry of Health and Family Welfare, Government of India; 2009. p. 12.
9. Wortley PM, Chu SY, Diaz T, Ward JW, Doyle B, Davidson 3. AJ, et al. HIV testing patterns: where, why, and when were persons with AIDS tested for HIV? AIDS 1995; 9 : 487-92.
10. Kumarasamy N, Solomon S, Chaguturu SK, Cecelia AJ, 4. Vallabhaneni S, Flanigan TP, et al. The changing natural history of HIV disease: Before and after the introduction of generic antiretroviral therapy in Southern India. J Clin Infect Dis 2005; 41: 1525-8.
11. C.N. Deivanayagam, S. Rajasekaran, V.Senthilnathan, 0.R. Krishnarajasekhar, K. Raja, C. Chandrasekar, S. Palanisamy, A. Samuel Dinesh, G. Jothivel and S. V. Elango Clinico-radiological spectrum of tuberculosis among HIV sero-positives - a Tambaram study .Ind. J Tub., 2001,48, 123.
12. Zuber Ahmad, Rakesh Bhargava, D.K Pandey and K. Sharma HIV infection seroprevalence in tuberculosis patients Ind.J.Tub.,2003,50,151
13. Praveen Kumar, Niraj Sharma, N.C. Sharma. Clinical Profile of Tuberculosis in Patients with HIV Infection/AIDS. Indian J Chest Dis Allied Sci 2002; 44: 159-163
14. Anand K. patel, sandip j. thakrar, feroz d. ghanchi. Study on clinical and laboratory profile of patients with TH/HIV coinfection: a case series of 50 patients.lung india 2011:28;93-6.
15. Surendra K. Sharma, Manish Soneja, K.T. Prasad & Sanjay Ranjan. Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India. Indian J Med Res 139, January 2014, pp 154-160