Pattern of pulmonary infection and immunological profile of seropositive HIV with pulmonary tuberculosis patients: A tertiary care hospital based study in Odisha
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 3
Abstract
Abstract: There is a growing concern regarding opportunistic infections associated with seropositive HIV with pulmonary tuberculosis. Hence the present study was carried out with an objective to find out the pattern of pulmonary infection and their association with immunological profile among the HIV- TB co-infected patients registered in a tertiary care referral unit of Odisha. In this retrospective study the diagnosed cases of pulmonary TB with HIV co-infection, having other pulmonary manifestations registered within June 2013 to May 2016 (three years) were included. The extra pulmonary TB cases were excluded. The detailed basal characteristics, sputum culture characteristics and CD4 count of all included patients were noted. In this study, maximum cases were within age range of 31-45 years (35.29%) and males outnumbered females (M: 73.53%; F:26.47%). Majority of them were from rural community (92.65%). Only 30.88% of all were on antiretroviral therapy. 58. 82% of all had CD4 count below 200/µl. In sputum culture, only bacterial growth, only fungal growth and mixed bacterial as well as fungal growth was seen in 17.65%, 27.94% and 20.59% of samples respectively. Among all, isolation of mixed organisms, like Streptococcus, Staphylococcus with Klebsiella and Pseudomonas was observed in maximum samples. Next to it, staphylococcus growth was seen in 15.48% samples. Among fungi, Candida albicans was predominant (42.42%) organism isolated in sputum. In 21.21% samples, there was mixed infection of Candidaalbicans with Candida glabrata, Aspergillusflavus, Candida tropicalis, Candida parapsilosis etc. On bivariate analysis, a significant (p<0.05) correlation was observed between CD4 count and bacterial and or fungal infection. From this study it is concluded that CD4 count (immunity status) is the primary determinant of opportunistic pulmonary infection in our setting. So early diagnosis and appropriate treatment of co-infections is needed to reduce morbidity and mortality in TB-HIV patients. Keywords:Pulmonary Tuberculosis, HIV/AIDS, Co-infection, Opportunistic infection, CD4 count, Bacterial and fungal infection
Authors and Affiliations
Nalini Prava Das, Bandana Rath, Y Roja Ramani
Keywords
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