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Category: Volume 08 Issue 05 May 2020
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Title: Clinical and Radiological Profile of Pulmonary Tuberculosis in HIV Seropositive Patients in Relation to CD4 Count

Authors: Dr Mohammed Hidayath Hussain, Dr Hina Afreen

 DOI: https://dx.doi.org/10.18535/jmscr/v8i5.59

Abstract

 

Background: Tuberculosis and HIV make up a synergistic and devastating partnership, each exacerbating & quickening the progression of the other Infection with HIV being the most powerful known risk factor predisposing for Mycobacterium tuberculosis infection and progression to active disease. The risk of tuberculosis in HIV‐infected persons continues to increase as HIV disease progresses and CD4 cell count decreases. Thus co infection with HIV and tuberculosis is not only a medical malady, but a social and an economic disaster and is aptly described as the ‘cursed duet’. Understanding the clinical and radiological profile of the HIV-Tuberculosis co-infection is of great importance because of increasing prevalence of co-infection, severity of clinical presentation of tuberculosis in HIV- positive patients, rapid progression of HIV disease in tuberculosis patients, and challenges in treatment of co-infected patients given possibly of drug interactions and immune reconstitution syndrome.

Methods: Hospital based cohort study was done for a period of two years at a tertiary care hospital. This study was carried on 110 patients with HIV & TB co infection. Diagnosis of tuberculosis apart from clinical manifestations is based on sputum for acid fast bacilli and chest X- ray to know the extent of the disease.AFB positive smears were graded as per RNTCP guidelines.CD4 count was done for the serum samples found positive for HIV.

Conclusions: The clinical manifestations of tuberculosis in HIV infected patients are quite varied and generally show different pattern in relation to CD4 cell count. Patients with low CD4 count presented with more number of symptoms. The majority of patients with HIV-related pulmonary tuberculosis in this study had atypical radiological presentation when CD4 count was <200/µl.

Keywords: pulmonary tuberculosis, HIV seropositive patients, CD4 counts.

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Corresponding Author

Dr Hina Afreen

Post Graduate, Department of Pulmonary Medicine, Shadan Institute of Medical Sciences, Hyderabad Telangana State, India