TUBERCULOSIS IN PATIENTS LIVING WITH HIV/AIDS: TYPES AND ITS RELATION TO CD4 COUNT

Abstract

Introduction: TB is the most common opportunistic infection and a leading killer of people living with HIV/AIDS (PLWHA). HIV not only increases the number of TB cases, but also alters the clinical course of TB disease. As HIV related immunosuppression increases, the clinical pattern of TB changes, with increasing numbers of smear-negative and extrapulmonary cases.

Methodology: Total 100 HIV positive patients diagnosed with Tuberculosis and having age more than or equal to 18 years were selected randomly from the list obtained from ART centre using random number table. Detailed clinical and laboratory investigations were done in all patients.

Results: Common presenting symptom in this study was fever (91%), cough (65%), anorexia (62%), weight loss (61%), diarrhea (58%) and breathlessness (36%). Out of total 100 study participants, 54 were having pulmonary tuberculosis and 46 were having extrapulmonary tuberculosis. In extrapulmonary TB Spleen (41%) was most commonly involved followed by Lymphnode (39%), pleural effusion (12%) and meningitis (8%). Among pulmonary TB patients maximum number of patients 24 (44.44%) were having CD4 count 100 - 199 per mm³. Among Extrapulmonary TB patients, maximum number of patients 28 (60.87%) were having CD4 count 100 -199 per mm³.

Conclusion: The presenting symptoms of tuberculosis in PLHIVs were not different from those of non HIV patients. Generally patients with low CD4 count presents with atypical form of tuberculosis.