Manifestations of Tuberculosis in TB-HIV co-infected patients: A retrospective study

Abstract

Background: Tuberculosis (TB) is one of the common opportunistic infection and the main cause of death among HIV/AIDS patients. Diagnosis of TB in HIV/AIDS patients has been difficult due to atypical manifestations of TB in these patients

Broad objective: The main objective of the present study was to examine the common clinical and radiological manifestations of tuberculosis in association with immune status in HIV-TB co-infected patients

Methodology: Retrospective data of 339 HIV/AIDS patients co-infected with TB attended at Sekou Toure regional hospital between January 2007-May 2010 were collected. Information such as age, sex, baseline CD4 T cell counts, presented symptoms and form of TB were recorded and analyzed by Statistical package for social sciences (SPSS) version 17.0.

Results: Out of 339 patients, 165(48.7%) were females and 174 (51.3%) were males with mean age of 35 years. Of all the symptoms recorded, cough was the commonest symptom 320 (94.4%), recorded followed by weight loss 235(69.3%), fever 233(68.7%), night sweats 122(36%), anorexia 78(23%) and chest pain 27(8%) respectively. Radiological findings showed that pulmonary TB (PTB) was present in 310(91.4%) and extra pulmonary TB (EPTB) 48 (14.2%) patients respectively. Patients with both EPTB and PTB were 20(5.9%). Pleura effusion (50%) and adenitis (27%) were the common forms of EPTB. Acid fast bacilli results showed that, 112(33.04%) of the patients were AFB positive. Smear negativity rate was significantly high among patients with CD4 T cell count ≤ 400cells/μl (P=0.0001). Patients with TB symptoms and other clinical symptoms had significant low CD4 T cell counts (≤ 200 cells/μl) (P=0.0001).

Conclusions and recommendations: PTB with typical and atypical features was the most common manifestation of TB in HIV/AIDS co-infected patients. EPTB was also common and mostly in form of pleura effusion and adenitis. Low CD4 T cell counts were associated with high smear negativity rate and presence of other conditions in patients with TB symptoms. Sufficient knowledge of TB manifestation in HIV/AIDS patients is necessary for proper diagnosis of TB in HIV/AIDS patients. Moreover standardized diagnosis and optimization of case detection rate in HIV/AIDS needs to be adopted.

Key words: Tuberculosis, HIV/AIDS, manifestations, opportunistic infections