Prospective study of tubercular co-infection in HIV infected patients in VIMSAR, Burla, Sambalpur, Odisha, India

Abstract

Background: Tuberculosis is the most common opportunistic infection in HIV positive patient. This is a major challenge faced by HIV positive patient. Methods: This study was carried out at Medicine Department and ART Centre, VIMSAR, Burla to know the epidemiology and clinical profile of HIV and TB co-infection. This is a prospective study in which all adult patients attending to our hospital for period of one year with HIV-TB co infection are enrolled. There were 269 patients. The clinical parameters are studied after all detailed history and clinical examination. The diagnosis of Tuberculosis was made by relevant investigation like Sputum AFB, Chest X-ray, CSF Study, CT Scan, Pleural Fluid Study, Ascitic fluid study etc.Results: The results indicate majority of the patients out of 211 patients 74 (82.52%), were male 34(16.35%)were female and TGTS were-3(1.42%). Age group mostly affected were 26-35 years (38.1%) and 36-45 years (38.1 %). Extra-pulmonary TB constituted 56.28% and Pulmonary TB-43.72%. 41.99% completed anti-TB treatment and mortality was 12.99%. Mean CD4 count at the time of diagnosis-218iu/l; and patients with low CD4 cell count at the time of diagnosis had high mortality.Conclusions: Extra-pulmonary TB is predominant among HIV TB co-infection and the working-class population affected more than the rest TB Meningitis and Disseminated TB are associated with a bad prognosis when compare to other forms of TB. A low CD4 count at the time of Tuberculosis diagnosis is associated with a higher mortality and early suspicion diagnosis of tuberculosis and early initiation of ATT in HIV patients reduces mortality and morbidity significantly.