A Study on the Clinical Presentation of Hiv-Tb Coinfection and Its Correlation with Cd4 Count
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 4
Abstract
Objectives: The aim of this study was to determine and compare the clinical presentation of pulmonary tuberculosis (PTB) and its correlation with CD4 count in groups of patients with and without human immunodeficiency virus (HIV) infection in ART & CHEST clinic in kilpauk Medical College Hospital, Chennai, Tamilnadu, Chennai. Materials and Methods: A total number of 60 patients of HIV + ve TB and 30 patients HIV –veTB were enrolled in this study. All patients were meticulously examined for the presence of Pulmonary and Extra pulmonary tuberculosis. Their symptoms were analyzed in a detailed manner. Complete general examinations for the presence of opportunistic infection and respiratory system and other system examination were done All of them were subjected to the following investigations. Basic blood investigation, sputum smear for AFB, chest x ray PA view, PPD reactivity by mantaoux test and CD4 count. Special investigations were done in patients with extra pulmonary TB like FNAC of lymph node , biopsy, and CSF analysis Results: Out of all participant males are commonly infected (68%). the common age affected is between 36-45. pulmonary tuberculosis is most common than extra pulmonary TB(62% vs 38%). On analyzing the sites of extra pulmonary TB are occurs in the following orders- lymphnode(46.67%), pleura(33.33%), pericardium, meninges(6.67%), GIT(46.67%), GUT, bone(46.67%) and others. On analyzing symptomatology of pulmonary TB , almost all the cardinal symptoms are present in both groups , but fever(88.89%) and weight loss(91.11%) are the commonest presenting symptoms of HIV-TB. Whereas, cough with expectoration(84.62%) and hemoptysis(38.46%) are common in non HIV-TB group. smear negative is more common in HIVTB(78.3%).HIV-TB patients often shows induration within 0-5 mm with mantoux test. Candidiasis is more commonly seen in HIV-TB patients(38.33%). Conclusion: As TB is the most common opportunistic infection in all HIV positive individuals , hence all HIV patients should be screened for TB and all TB patients should be screened for HIV status. males are more commonly infected. Tuberculosis has multiple clinical presentations in patients with HIV infection . Sputum smear negativity is more common, hence sputum culture is essential as a screening procedure. Mantoux test often is false negative in HIV-TB co infection. Lymphnodes, meninges and pleura are the common sites of extra pulmonary TB involvement. Tuberculosis can occur at any level 0f depletions of CD4 cout. Since TB-HIV fuel each other , early diagnosis And proper effective management are essential to reduce the morbidity and mortality.
Authors and Affiliations
DR. S. Malathi MD, DR. S. Geetha MD, DR. V. Madhavan MD, DR. Vijay Usharaj MD
Keywords
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- EP ID EP594162
- DOI 10.9790/0853-1604052632.
- Views 36
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