SPECTRUM OF PULMONARY TUBERCULOSIS IN HIV POSITIVE PATIENTS WITH SPECIAL REFERENCE TO CD4 COUNTS.

H. O. Gupta, R. Patel, Rakesh Tikadar

Abstract


INTRODUCTION: Tuberculosis is one of the commonest opportunistic infections in HIV positive patients. Person with
HIV is upto-30 times more likely to develop active TB than normal individual.
OBJECTIVE: To evaluate the spectrum of PTB in HIV patients, CD4 count in PTB of HIV patients, how CD4 count affect the
PTB in patients.
MATERIAL AND METHODE: This is a PROSPECTIVE OBSERVATIONAL STUDY of 150 patients with age >15 year.
INCLUSION CRITERIA: All HIV positive patients with sputum positive or sputum negative PTB.
EXCLUSION CRITERIA: All extrapulmonary tuberculosis.
RESULTS: Middle aged 26-45years (68%) individual are most commonly affected especially the rural population
(84.7%). The population which are more commonly affected is the low education status individuals (primary and high
school each of 35%) but among the female uneducated group are more common. Most common mode of transmission in
decreasing order are sexual (75%), blood and its product (21%), IVD users (4%). Most common symptoms are cough
(93%), weight loss (81%), fever (67%). Out of 150 patients, 15% are sputum AFB positive and 45% are CBNAAT positive.
In patients with CD4 count below 200, atypical involvement (bilateral, lower lobe, consolidation and miliary mottling) is
more common than typical (apical region, cavitary lesion) involvement.
Conclusion: There is a need for better diagnostic test to detect PTB other than sputum smear examination in HIV patient
especially among CD4<200. CXR remains an important diagnostic tool for PTB in HIV patients, but in patients with
CD4<200 atypical involvement of lung is common (lower zone, b/l, consolidation) than typical involvement (apical lobe,
cavitary lesion). So it is necessary for the accurate and timely diagnosis of tuberculosis in HIV patient with CD4<200
sputum smear negative and atypical lung involvement


Keywords


HIV, TB, PTB, CD4 Count

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