Tuberculosis in HIV/AIDS patients in a tertiary care hospital in Delhi
Agarwal, S.K.; Aman Makhija; Singh, N.P.; Anupam Prakash; Baveja, U.K.
Indian Journal of Tuberculosis 50(3): 163-165
2003
ISSN/ISBN: 0019-5707 Document Number: 253933
Between January 2001 and April 2002, a study was conducted to examine the prevalence and clinico-radiological profile of tuberculosis (TB) in human immunodeficiency virus (HIV) seropositive patients at the Department of Medicine in Maulana Azad Medical College and AIDS Division at the National Institute of Communicable Diseases in Delhi, India. Of 80 HIV seropositive cases, TB was present in 31 (33.75%) patients. Twenty-one (67.7%) had pulmonary TB while extrapulmonary TB was diagnosed in 10 (32.3%) patients. Sputum staining for acid fast bacilli was positive in eight (30.8%) patients with TB. HIV positive patients with pulmonary TB had both typical (57.1%) and atypical (42.8%) radiological lung manifestations. Mean CD4 cell counts were significantly lower (P<0.01) in HIV seropositive patients with TB as compared to those without TB. CD4 cell counts were significantly higher (P<0.01) in patients with apical/upper zone lung lesions when compared to patients with atypical radiological manifestations. Oral thrush (9.7%), oesophageal candidosis (6.5%), recurrent/multi-dermatomal herpes zoster (6.5%), central nervous system toxoplasmosis (3.2%) and chronic diarrhoea due to Cyclospora infection (3.2%) were the other opportunistic infections diagnosed among HIV seropositive patients with TB. It is concluded that TB is the most common opportunistic infection seen among HIV patients in Delhi. Difficulties in diagnosis posed by varied clinical manifestations, low sputum positivity and higher incidence of atypical radiological presentations, together with the problems in management, must be considered by the physician while dealing with any episode of TB in HIV-infected persons.