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HIV IN TUBERCULOSIS.

ABSTRACT: This study was undertaken to evaluate clinical and laboratory parameters of 29 HIV-infected male patients with tuberculosis. Out of the 243 human immune deficiency virus (HIV) seropositive patients, 15 (6.2%) were diagnosed to be suffering from tuberculosis whereas out of 3502 cases of tuberculosis random HIV surveillance in 350 cases showed HIV infection in 14 (4%). Mantoux positivity at the time of diagnosis of tuberculosis was noted in 16 (55.1%) patients, and out of them 17.1% showed tuberculin conversion within 2 years of detection of HIV infection. Diagnosis of tuberculosis was based on demonstration of acid fast bacilli in sputum of 8 (27.6%), and in lymphnode aspirate in 4 (13.8%). Tubercular granuloma was demonstrated in 3 more patients, 2 in lymphnodes and one in liver parenchyma. In another 14 cases, there was classical clinical presentation and chest radiogram findings with excellent therapeutic response. Chest radiograms showed pulmonary infiltrate in 20, pleural effusion in 5, pleural thickening in 2, and intrathoracic adenopathy in 6 patients. Exclusive extrapulmonary tuberculosis was present in 4 patients.

SUBMITTER: Jayaswal R

PROVIDER: S-EPMC5530203 | biostudies-other | 1995 Oct

REPOSITORIES: biostudies-other

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Project description:Tuberculosis (TB) continues to be the leading cause of death for people living with HIV/AIDS (PLHIV), and HIV is the strongest known risk factor for progression to active TB disease for persons with latent TB infection (LTBI). Screening for active TB and LTBI, and TB preventive therapy (TPT) is recommended, however, clinical practices regarding LTBI screening for HIV positive population have not been uniform, resulting in low rates of LTBI screening and TPT uptake, in both low and high TB-burden countries. We sought to explore the practices and attitudes towards TB and LTBI screening in PLHIV among HIV physicians in Japan. We conducted a cross-sectional survey whereby an on-line questionnaire was administered to physicians who are currently, or have the experience of, providing care and treatment for PLHIV in Japan. The questionnaire was sent to a total of 83 physicians, of which 59 responded (response rate; 71.1%). 52.5% (31/59) conducted routine screening and 44.0% (26/59) conducted selectively screening for active TB among HIV/AIDS patients. As for LTBI, 54.2% (32/59) conducted routine screening and 35.6% (21/59) conducted selective screening for LTBI among PLHIV. "T-SPOT only" was the most frequently used method of screening (n = 33), followed by "QFT only" (n = 11). Criteria for LTBI screening included TB burden in the country of birth of the patient, previous contact with a TB patient, and CD4+ cell count. 83.1% (49/59) either "always" or "selectively" offered TPT to PLHIV diagnosed with LTBI, and among the 49 respondents who did provide TPT, 77.6% (38/49) chose 9-months isoniazid as their first choice. None chose regimen including rifampicin. Our study revealed that practices regarding TB and LTBI screening and treatment for PLHIV among HIV physicians were mixed and not necessarily in accordance with the various published guidelines. Building and disseminating scientific evidence that takes into consideration the local epidemiology of TB and HIV in Japan is urgently needed to assist physicians make decisions.

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HIV IN TUBERCULOSIS.

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