Tuberculosis In Human Immunodeficiency Virus Patients Research Articles

Urine lipoarabinomannan levels in pulmonary tuberculosis with and without HIV coinfection

Background. Pulmonary tuberculosis (TB) is an opportunistic infection that occurs more frequently in individuals with weakened immune systems, such as those with Human Immunodeficiency Virus (HIV). Diagnosing pulmonary TB in HIV patients can be particularly challenging. One alternative diagnostic method for TB involves detecting TB antigens through the lipoarabinomannan (LAM) test using urine samples. The aim of this study was to perform a comparative analysis of urinary LAM levels in pulmonary TB patients with and without HIV co-infection. Methods. This study was an analytical observational study with a cross-sectional design, conducted on all adult pulmonary TB patients aged 18 years and older, with and without HIV co-infection. A chi-square statistical test was used, with a significance level of p <0.05. Results. Data analysis was performed on 72 subjects with pulmonary TB, with 36 subjects in each group (with and without HIV co-infection). A comparative analysis of urinary LAM levels showed that pulmonary TB co-infected with HIV had a higher number of positive LAM cases (14 subjects, 19.44%) compared to pulmonary TB without HIV co-infection (5 subjects, 6.94%), with a p-value of 0.016, indicating a significant difference. Conclusion. The detection of urinary LAM levels in pulmonary TB patients co-infected with HIV showed positive results that were 3.945 times higher than in pulmonary TB patients without HIV co-infection.

Human Immunodefiency Virus Infection in Tuberculosis Patients at Kotaraja Health Center of Papua

Human Immunodeficiency Virus (HIV) is a virus that attacks white blood cells and causes the human immune system to decrease. Tuberculosis in HIV patients is an opportunistic infection that will aggravate the disease infection in patients. Examination of HIV (Human Immunodeficiency Virus) in Tuberculosis Patients was carried out at the Kotaraja Health Center. This study was conducted for 1 month starting from May 17, 2019, to June 07, 2019. The purpose of this study was to determine HIV in tuberculosis patients at the Kotaraja Health Center. This type of research is descriptive with a laboratory test approach. The sample used is a serum sample with a diagnosis of HIV. The method used in this examination is the Rapid Test method. The results of HIV testing on tuberculosis patients, sample data obtained from HIV tuberculosis co-infected respondents amounted to 30 HIV respondents who took tuberculosis treatment >6-9 months, negative 6 patients (20%).

Association of Micronutrients with Tuberculosis Development in HIV Infected Patients.

Human immunodeficiency virus (HIV) infection associated with weakened immune system due to decreased CD4 T cell count favors development of tuberculosis. Effector immune responses are also associated with micronutrient status due to their prominent role in maintaining immune functions. Micronutrient deficiencies are quite common among HIV patients that further result into compromised immunity thus making the conditions even more favorable for mycobacteria to establish disease. So, current study was designed to assess association of different micronutrients with development of TB in HIV patients. Micronutrient levels were measured in asymptomatic HIV patients who were monitored for the development of TB during follow up period (incident TB) within one month to one year and also in symptomatic microbiologically confirmed HIV-TB patients. Among various micronutrients assessed, levels of ferritin were found to be significantly increased (p < 0.05) with significant decreased zinc (p < 0.05) and selenium (p < 0.05) levels in incident TB group as well as in HIV-TB subjects compared to asymptomatic HIV patients who did not develop TB in the follow up period. Importantly, increased levels of ferritin and decreased levels of selenium were significantly associated with development of tuberculosis in HIV patients.

An Application of the Growth Model to HIV/AIDS Patients on Antiretroviral Therapy with Coinfections in a District Hospital in Ghana

Lethal opportunistic diseases like Tuberculosis and Hepatitis C are deeply ingrained complications for patients diagnosed with human immunodeficiency virus (HIV). The effect of Highly Active Antiretroviral Therapy (HAART) on Hepatitis C and Tuberculosis in HIV patients in Ghana continues to be unpredictable, especially in younger patients. This study aimed to describe the patient survival time distribution on antiretroviral treatment using Statistical Growth model. A retrospective cohort of 634 patients aged between 22 to 73 years were selected from the District Health Information Management System 2 (DHIMS 2), a secondary source, using a random sampling approach. These patients were diagnosed with HIV and started antiretroviral therapy between 2000 and 2019 at St. Martins Catholic Hospital in Amansie South District of the Ashanti Region. The probability of survival for almost all of the risk factors decreases gradually at different clinical states, i.e., from state 1 through to state 4. Hepatitis C or Tuberculosis can also be diagnosed chronically in approximately one in ten patients. Age, sex and the CD4 cell count of patients substantially (p- value =0.001 in log-rank tests) contributed to the prevalence of human immunodeficiency virus. Survival of infants, aged &lt;1year, after treatment was of negative effect. The statistical growth analytical approach offers a good estimate of survival rate ( 79.82%) among major risk factors for infants, aged &lt;1yearon ART with proportion of survival growth of 0.95, hence the survival time of infants, aged &lt;1yearon HAART is negatively affected irrespective of the treatment initiation period.

Association of Urinary Interferon Gamma Protein-10 Levels and Low Levels of Cluster of Differentiation 4 Serum in Patients with Tuberculosis-Human Immunodeficiency Virus Coinfection

BACKGROUND: Tuberculosis (TB) infection caused by Mycobacterium tuberculosis was the most frequent opportunistic infection in human immunodeficiency virus (HIV) patients that lead to increasing of morbidity and mortality. Very low cluster of differentiation 4 (CD4) levels causing problem in TB/HIV diagnostic because unspecific clinical manifestation. Urine interferon gamma protein-10 (IP10) examination is a method that is relatively easier and safer to do, so it can be used as an alternative method in establishing the diagnosis TB/HIV. AIM: The aim of this study was to investigate the association between urinary IP-10 and level of CD4 serum in patients with TB/HIV coinfection. MATERIALS AND METHODS: This study was conducted at the Department of Internal Medicine, Faculty of Medicine, Dr. M. Djamil Hospital, Padang, Indonesia, involved 30 patients with active TB/HIV coinfection whose urine and blood serum were collected to evaluate IP-10 and CD4 level. RESULTS: There is a significant relationship between urine IP10 levels as a biomarker for the diagnosis of active pulmonary TB in HIV patients and serum CD4 levels in TB-HIV coinfected patients with moderate correlation strength. CONCLUSION: Further research is needed with a larger sample size to see the effect of low serum CD4 levels on the sensitivity of urine IP10 diagnosis.

Genotyping and Drug Susceptibility Patterns of M. Tuberculosis Isolated from HIV Seropositive Patients in Tehran Iran

to investigate the prevalence and drug-resistance M. tuberculosis isolated from HIV seropositive individuals in Tehran, Iran. Human immunodeficiency virus (HIV) is one of the most important risk factors for developing active tuberculosis (TB). To determine the rate of transmission and drug resistant M. tuberculosis (MTB) strains isolated from HIV seropositive patients in Tehran province, Iran. This study consecutively enrolled 217 TB/HIV coinfected patients from April 2018 to August 2019 at Emam Khomeini referral hospital and 5 other health centers in Tehran province. The isolates were genotyped using 15 loci Mycobacterial interspersed repetitive unit-variable number tandem repeats (MIRU-VNTR). Minimum inhibitory concentration (MIC) was determined for 6 drugs. In addition, mutations were assessed in rpoB, katG, inhA, and ahpC genes using Reverse Blot Hybridization Assay System. A 20 (9.2%) patients were culture-positive for M. tuberculosis and typed by MIRU-VNTR, 13 (65%) strains formed 5 clusters, but 6 (30%) isolates had a unique pattern. The total Hunter-Gaston discrimination index (HGDI) for all 15 loci was 0.846, and the cluster size was 2 to 4 patients. The estimated proportion of recent transmission was 45%. The mutation was identified in 1 isolate, lost inhAW1 and mutation in MT1 loci, which was resistant to isoniazid (INH). Moreover, 1 (5%) and 3 (15%) isolates were resistant to INH and ethambutol (EMB), respectively, of which 1 was resistant to INH and EMB. The transmission rate of TB in HIV patients was relatively high; however, the prevalence of drug-resistant strains and TB infection in females was insignificant in this study (p < 0.05); none of the isolates was MDR strains.

Study on the Prevalence of Tuberculosis in HIV Seropositive patients attending the ART Centre, KIMS, Hubli

Background: The incidence of Tuberculosis (TB) has seen a significant rise in association with HumanImmunodeficiency Virus (HIV) infection worldwide, in the recent years. It is evident that immunosuppressiondue to the HIV infection has resulted in modification of the clinical presentation of TB, thereby presentingwith atypical signs and symptoms, and also sometimes affecting extra-pulmonary sites.Objectives: To determine the pattern of presentation and prevalence of TB in HIV Seropositive patients andto study various socio-demographic factors associated with the same seen in the patients attending the AntiRetroviral Therapy (ART) Centre, Karnataka Institute of Medical Sciences (KIMS), Hubli.Methods: A cross-sectional study was conducted among 109 HIV Seropositive patients attending ARTCentre in KIMS, Hubli, for a period of 2 months. A pretested, semi-structured questionnaire was applied tocollect the data from the study participants after obtaining the verbal informed consent.Results: The prevalence of HIV-TB among the study participants was estimated to be around 34.9%.Although HIV infection was found to be more in females in the study, TB with HIV infection was seenmajorly in males. The commonly affected age group was 31-40 years, both in HIV infection alone and TBco-existing with HIV. Pulmonary TB was the commonest type of TB i.e., 92.1% among the HIV patients ofthe study. The prevalence of TB was found to be maximum in the cases with CD4 count of range less than250 cells/cu.mm.Conclusion: The prevalence of TB in HIV Seropositive patients was more than one third as per the studyand hence it is of utmost concern that HIV patients should be screened and treated for TB as early aspossible, and the prophylaxis of TB in HIV patients must be considered.

Immunoendocrine interactions during HIV-TB coinfection: implications for the design of new adjuvant therapies.

Worldwide, around 14 million individuals are coinfected with both tuberculosis (TB) and human immunodeficiency virus (HIV). In coinfected individuals, both pathogens weaken immunological system synergistically through mechanisms that are not fully understood. During both HIV and TB infections, there is a chronic state of inflammation associated to dramatic changes in immune cytokine and endocrine hormone levels. Despite this, the relevance of immunoendocrine interaction on both the orchestration of an effective immune response against both pathogens and the control of the chronic inflammation induced during HIV, TB, or both infections is still controversial. The present study reviews immunoendocrine interactions occurring during HIV and TB infections. We also expose our own findings on immunoendocrine cross talk in HIV-TB coinfection. Finally, we evaluate the use of adrenal hormones and their derivatives in immune-therapy and discuss the use of some of these compounds like the adjuvant for the prevention and treatment of TB in HIV patients.

HIV-Tuberculosis: A Study of Chest X-Ray Patterns in Relation to CD4 Count

Background:Fight against human immunodeficiency virus (HIV) is incomplete without addressing problems associated with difficult diagnosis of tuberculosis in HIV-Tuberculosis coinfected patients. Chest X-ray is a primary tool to evaluate tuberculosis in HIV.Aim:To assess and compare various radiological patterns of pulmonary tuberculosis in HIV patients and compare these patterns in relation to CD4 counts.Materials and Methods:Prospective cohort study was conducted in a tertiary hospital in South India from September 2009 to July 2011 with 200 HIV positive patients. WHO guidelines were used for diagnosis of HIV and tuberculosis.Results:27% of the patients had sputum positive pulmonary tuberculosis, with higher incidence (33%) among CD4 less than 200 as compared to CD4 more than 200 (14%). Infiltration (39%) followed by consolidation (30%), cavity (11%), and lymphadenopathy (9%) seen with CD4 less than 200. Infiltration (37.5%) followed by cavity (25%) and miliary (25%) with CD4 above 200. Bilateral (68.5%) and mid and lower zones or all zone involvement more commonly seen.Conclusion:In patients with CD4 lower than 200 noncavitory infiltration and consolidation predominated. Involvement of lungs was atypical; diffuse or mid and lower zone involvement than classical upper lobe involvement. A high index of suspicion is necessary for the accurate and timely diagnosis of tuberculosis in HIV positive patients.

TB in HIV Patients: Strengthening Control Measures

It is clear that there are several factors e.g. the increasing disparities in wealth, health inequality leading to poor access to health services, free movement of individuals across the globe thus spreading infectious diseases and lack of commitment of some governments of the world poorest countries towards provision of adequate health care services to the populace, that led to the upsurge in number of Tuberculosis (TB) cases seen in recent times across the globe and more to the sub-Saharan Africa. this rise is not unrelated to the rise of the prevalence HIV (Human Immunodeficiency Virus). It is very clear that airborne route is the most common route of transmission for greater majority of TB cases seen. This is worsened by continual interaction of patients wit overt TB and those with HIV infection in the community, clinics or hospitals. Although most of those immune-competent individuals exposed to the TB pathogen (M. Tuberculosis) do not become infected, the disease seen in HIV immune-compromised patients occurs either as a new infection, re-infection or reactivation as a result of poor cellular immunity. Several studies have shown that despite increase funding towards fighting the infectious diseases across the globe, the population especially on the sub-Saharan continent are now more susceptible to tuberculosis. This is partly as a result of increase prevalence of HIV on the Africam continent leading to lack of cellular immunity on this patients. It is also important to note that there is loss of priority by policy makers in some of these countries diverting resources meant for effective TB control to other health programmes, which they consider more important especially in the short term. This review, discusses the importance of streghthening different TB control measures both in the community and hos[pital environment to be able to reduce the increases in cases of TB seen in HIV patients and further prevent the emergence of drug resistant TB.Keywords: Human immunodeficiency virus, tuberculosis, multidrug resistance TB, surveillance, outbreak

Diagnostic value of an immunochromatographic test over clinical predictors for tuberculosis in HIV patients

Purpose:The value of an immunochromatographic test for tuberculosis (ICT-TB) combined with clinical predictors has yet to be evaluated in Thailand. This study aimed to assess any additional diagnostic value of an ICT-TB test over that of clinical predictors in a group of human immunodeficiency virus (HIV) patients as well as in subgroups of HIV patients classified by clinical risk scores.Patients and methods:An extended cross-sectional study was conducted at a community hospital in Chiang Rai and a general hospital in Lampang. HIV patients registered between April 2009 and May 2010 were screened by a locally made ICT-TB test, including 38, 16, and 6 kD Microbacterium tuberculosis antigens, as well as by routine evaluations for TB diagnosis. Demographic data, medical history, signs, and symptoms were recorded. Participants were followed up for 2 months for final ascertainment of TB diagnosis.Results:Of 206 patients, 37 (18%) had TB. Four clinical predictors were identified: low body mass index (<19 kg/m2), prolonged cough (duration >2 weeks), shaking chills (≥1 week), and no use of antiretrovirals. The area under the receiver operating curve was 90.2%; adding the ICT-TB test result increased the area nonsignificantly to 91.6% (P = 0.40). When patients were categorized by risk scores derived from selected clinical predictors into low (scores ≤7) and high (scores >7) TB risk groups, a positive ICT-TB test increased the positive predictive value nonsignificantly in the low risk group (from 12.5% to 27.3%, P = 0.17) and the high risk group (from 78.6% to 80.8%, P = 0.73).Conclusion:In this study setting, the ICT-TB test did not enhance TB diagnosis over the four clinical predictors in the overall group or any subgroups of HIV patients classified by clinical risk scores.

Tuberculosis en pacientes infectados por el VIH

Tuberculosis is a clear example of infection that requires cellular immunity for its control. The spread throughout the world of the Human Immunodeficiency Virus (HIV) resulted in its interaction with tuberculosis altering the descending curve of the latter disease in some developed countries, and brought an aggravation of the problem in other countries with few economic and health resources and where tuberculosis was endemic. HIV increases the risk of reactivation of latent tuberculosis infection and accelerates progression after infection or reinfection; on the other hand, TB aggravates the prognosis of patients infected with HIV. This article sets out the differential aspects in the clinical manifestations of TB amongst populations with and without HIV infection; we also comment on some special characteristics in the treatment of tuberculosis in HIV patients. With the exception of primary cutaneous infections produced by accidental inoculation and infantile lymphadenitis, the majority of the cases of disease due to non-tuberculosis mycobacteria (NTM) affect patients with certain predisposing factors. In the case of patients with AIDS, the deep immunological disorder provoked by HIV brings a particular susceptibility to suffering invasive disease due to certain NTM, principally M. avium complex and M. kansasii.

Radiographic presentation of pulmonary tuberculosis in severely immunosuppressed HIV-seropositive patients

Although the presence of typical postprimary or “reactivation” pattern tuberculosis (TB) on chest radiograph (CXR) strongly suggests TB infection in adults, the sensitivity of this finding, particularly in severely immunosuppressed human immunodeficiency virus (HIV) patients, is unclear. To investigate this issue, HIV status, CD4 counts, and CXR findings of all adult patients with culture-proven TB admitted to a tertiary-care hospital over a 2-year period were retrospectively studied. CXRs were classified as typical for postprimary TB if they showed upper lobe opacities with or without cavitation. No attempt was made to correlate the actual clinical phase of TB infection (primary versus postprimary) with CXR patterns, largely because differentiating primary from postprimary TB in HIV patients is difficult due to high anergy rates and inability to skin-test-convert. Of 46 patients who had chest radiographs and medical records documenting HIV status available for review, 23 were HIV-seropositive and 23 were HIV-seronegative. Of 22 HIV-seropositive patients whose CD4 counts were available, 18 (82%) had CD4 counts of <200 cells/μL. Only 2 of these 18 (11%) had CXRs showing a typical postprimary TB pattern, whereas all 4 (100%) patients with CD4 counts of 〉200 cells/μL and 18 of 23 (78%) non-HIV patients had CXRs typical for postprimary TB ( P < .005). It was concluded that HIV-seropositive patients with TB and CD4 counts of <200 cells/μL frequently present with chest radiographs atypical for postprimary TB, including normal CXRs. Typical postprimary TB CXR findings are not sensitive for diagnosing pulmonary TB in this population.