PROFILE OF TUBERCULOSIS PATIENTS IN PERSON LIVING WITH HIV (PLHIV) AND THEIR RELATIONSHIP WITH CD4 COUNTS

Abstract

Background- This study aims to observe prole of TB in PLHIV patients and their correlation with CD4 counts. Methods- This is a crosssectional observation study done from January 2021 to June 2022 in department of respiratory medicine GMC Bhopal. PLHIV patients between 12-60 years of age with clinico-radiological and microbiological evidence of TB were included. Patients with history of TB treatment with currently no evidence of active TB and with any chronic ailments were excluded to avoid bias. Results- Out of 100 patients, 53 patients had only pulmonary TB, 18 patients had only EPTB and 29 patients had disseminated TB. Pleural effusion was the most common EPTB (31.9%). In this study HIV-TB coinfection is more prevalent in male (70%) with maximum 40 cases in 30-40 year age group. According to CD4 counts 68 patients were in CD4 counts <200 cells/mm3. Most common clinical feature was cough (89%) followed by decrease appetite (88%), fever (85%), loss of weight (85%), expectoration (73%), dyspnea (46%) and night sweats (31%). Out of 100 cases, 31 cases detected by CBNAAT among which 16 cases also had positive sputum microscopy. Chest x-ray among 100 patients showed inltrates in 82 cases with maximum (70.7%) in CD4 counts<200 cells/mm3.Also chest x-ray showed inltrates with cavity in 14 patients with maximum (71.4%) in CD4 counts >500 cells/mm3. Conclusion- In this study, severity of clinical feature, radiological ndings, EPTB & disseminated TB cases increase as CD4 counts decrease. Overall pulmonary TB is still more common presentation. Also microbiological diagnosis is poor in lower CD4 counts due to paucibacillary disease. Presentation of TB become more atypical as CD4 counts decreases. .We recommend that special attention has to be given to all patients with low CD4 counts as they are more prone to atypical features, EPTB & disseminated TB.