English

Abstract

BACKGROUND: Tuberculosis, a major public health problem in most of the developing countries is posing a still bigger threat with the epidemic of HIV and association has been termed as cursed duet. There is significant difference in the clinical profile of tuberculosis in HIV infected compared to immunocompetent host. So prompt diagnosis and treatment of tuberculosis in HIV infected will improve the morbidity and mortality associated with dual infection. So the objective of the study was to determine the clinical profile of TB in HIV infected in relation to CD4 counts. MATERIALS AND METHODS: Hundred patients with HIV infection and having symptoms of tuberculosis admitted in the medical wards in Government General Hospital, Guntur were studied. Diagnosis of tuberculosis was based on clinical evaluation, sputum smears, bacteriological and biochemical examination of body fluids, histopathological studies and radiological studies. CD4 T cell counts were done in all patients. RESULTS: 51% had only pulmonary tuberculosis, 43% had only extrapulmonary involvement while 6% had disseminated disease. Sputum positivity was seen in 27.45% of pulmonary tuberculosis. Chest X-ray findings were mixed and varied with infiltrative lesions seen in 83.33% and fibrocavitatory lesions in 11.11%. 55.55% of infiltrative lesions were seen in mid and lower zones. Mean CD4 counts in this study was 133.78 ± 75 cells/μL. Most of the patients with extra pulmonary TB and disseminated TB had CD 200 cells/μL. CONCLUSION: Tuberculosis has a varied clinical presentation in patients with HIV infection. Sputum negative TB, extrapulmonary TB and disseminated TB were common when CD4 < 200 cells/μL and chest X-ray findings were atypical when CD4 < 200 cells/μL.