Influence of HIV infection on spectrum of extrapulmonary tuberculosis

Abstract

Introduction: Co-infection with human immunodeficiency virus (HIV) has changed both the clinical presentation and the outcome of tuberculosis (TB) dramatically in the last few decades. Material and Methods: We have analyzed a cohort of 190 patients with isolated forms of extrapulmonary tuberculosis (EPTB) with and without HIV-co-infection. All patients were under surveillance of Novosibirsk anti-TB dispensary from January 2015 – December 2016. Results: TB of the central nervous system (TB CNS) was diagnosed in HIV infected patients 8 times more frequently than in immunocompetent patients (accordingly 64.2% and 8.2%). Among Urogenital TB (UGTB) patients with HIV co-infection were found in 2.5% only. Also bone and joints TB was most common among immunocompetent patients as well as peripheral lymph nodes TB. Lymph node (LN) TB was diagnosed in four immunocompetent patients without HIV and in two patients with HIV co-infection. Conclusion: TB CNS developed eightfold more often in HIV-infected patients, while UGTB was diagnosed tenfold more often in immunocompetent patients. TB of bones and joints and LN TB were diagnosed twice more often in immunocompetent patients. Other forms of EPTB were revealed equally non-depending on HIV infection. HIV co-infection doesn’t mean worsening of TB by all means; we could see good outcomes in co-infected patient and poor – in patient without HIV infection.