Indian Journal of Health and Wellbeing

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

To Study Clinical Profile of PLHA (People Living with HIV/AIDS) with Tubercular Co-infection: A Prospective Study at Tertiary Care Centre in North India


Affiliations
1 Associate Professor, Department of Internal Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
2 Assistant Professor, Department of Internal Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
3 Ex. Professor, Department of Internal Medicine Govt. Medical College, Jammu, Jammu and Kashmir, India
4 Ex. Professor, Department of Pharmacology Govt. Medical College, Jammu, Jammu and Kashmir, India
     

   Subscribe/Renew Journal


People living with HIV/AIDS (PLHA) are at high risk of developing secondary infections, after seroconversion and with decreasing CD4 count the incidence of tuberculosis increases and adds to morbidity and mortality. Management includes concurrent treatment of HIV infection and specific management of tubercular infection. To study the clinical profile and disease outcome of tuberculosis in patients living with HIV/AIDS infection (PLHA). A prospective study from a tertiary care centre at Northern India. Patients with HIV/AIDS infection (PLHA) presenting with signs and symptoms of tuberculosis, diagnosed as cases of tuberculosis (pulmonary and extra pulmonary) were evaluated with respect to clinical profile, disease characteristics and socio demographic profile and respective data collected. 132 patients with HIV/AIDS infection diagnosed as cases of tuberculosis were included in study and data evaluated. Common clinical features included fever (84.4%), weight loss, (81.8%), cough with hemoptysis, followed by headache and altered sensorium. CD4 count <250 was significantly associated with tubercular infection with males effected more than females. Patients were diagnosed as having tubercular infection by AFB staining, Non-resolving pneumonitis on chest X-ray, HRTCT chest besides sputum culture, ESR, Monteux test, FNAC of lymph nodes and CSF study in extra pulmonary tubercular patients. The disease burden is more in developing and underdeveloped nations with high incidence of human immunodeficiency virus infection. Individuals infected with HIV infection may develop tubercular infection in course of HIV disease or may present with signs and symptoms of tubercular infection before being diagnosed as having HIV infection. The incidence of tubercular co-infection in PLHA is directly influenced by CD4 count and increases with fall in CD4 count. High degree of clinical suspicion with prompt evaluation for secondary infection including tuberculosis and timely management is associated with better outcomes.

Keywords

HIV/AIDS, tuberculosis, morbidity, mortality, treatment
Subscription Login to verify subscription
User
Notifications
Font Size


  • Dheda, K., Lampe, F.C., & Johnson, M.A. (2004). Outcome of HIV-associated tuberculosis in the era of highly active antiretroviral therapy. Journal of Infectious Disease, 190, 1670-1676.

  • Habib, A.G. (2009). A clinical and epidemiological update on the interaction between tuberculosis and human immunodeficiency virus infection in adults. Annals African Medicine, 8, 147-155.

  • Hirsch, H.H., Kaufmann, G., & Sendi, P. (2004). Immune reconstitution in HIVinfected patients. Clinical Infectious Disease, 38, 1159-1166.

  • Hung, C.C., Lee, H.C., & Hsieh, S.M. (2004). Effectiveness of highly active antiretroviral therapy and antituberculous therapy combinations among HIVinfected patients with active tuberculosis. San Francisco, CA: 11th Conference on Retroviruses and Opportunistic Infections, February 2004.

  • Irozindu, M.O., Ofondu, E.O., Mbata, G.C., Vanwyk, B., Hausler, H.P., Dh, A., Lynen, L., & Hopewell, P. C. (2016). Factors associated with prevalent tuberculosis among patients receiving highly active antiretroviral therapy in a Nigerian tertiary hospital. Annals of Medical and Health Science Research, pp. 120-128. Doi:10.4103/21 419248.181837

  • Kumarasamy, N., Chaguturu, S., & Mayer, K.H. (2004). Incidence of immune reconstitution syndrome in HIV/tuberculosis-coinfected patients after initiation of generic antiretroviral therapy in India. Journal of Acquired Immune Deficiency Syndrome, 37, 1574-1576.

  • Narasimhamurthy, D., & Thomas, D.M. (2018). Clinical profile and outcome of HIVTB co-infection at a centre of excellence for HIV care. Asian Journal of Medical Sciences, 9, 2.

  • Palchaudhuri, R., & Niggl, M.P. (2016). Eliminating HIV and AIDS in India: A roadmap to zero new HIV infections, zero discrimination and zero deaths. Indian Journal of Medical Research, 144, 789-792.

  • Prasad, R., Verma, S.K., & Kumar, Y. (2006). A clinico-radiological study of patients of tuberculosis with HIV co-infection. Current Medical Trends, 10, 1971-1977.

  • Ramachandran, R., Swaminathan, S., & Somasundaram, S. (2002). Mycobacteremia in tuberculosis patients with HIV infection. Indian Journal of Tuberculosis, 50, 29-31.


Abstract Views: 4978

PDF Views: 0




  • To Study Clinical Profile of PLHA (People Living with HIV/AIDS) with Tubercular Co-infection: A Prospective Study at Tertiary Care Centre in North India

Abstract Views: 4978  |  PDF Views: 0

Authors

Sanjay Fotedar
Associate Professor, Department of Internal Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
Vikas Bhatti
Assistant Professor, Department of Internal Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
Vinay Rampal
Ex. Professor, Department of Internal Medicine Govt. Medical College, Jammu, Jammu and Kashmir, India
Zahid H. Gilani
Ex. Professor, Department of Pharmacology Govt. Medical College, Jammu, Jammu and Kashmir, India
Surinder Kumar
Assistant Professor, Department of Internal Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India

Abstract


People living with HIV/AIDS (PLHA) are at high risk of developing secondary infections, after seroconversion and with decreasing CD4 count the incidence of tuberculosis increases and adds to morbidity and mortality. Management includes concurrent treatment of HIV infection and specific management of tubercular infection. To study the clinical profile and disease outcome of tuberculosis in patients living with HIV/AIDS infection (PLHA). A prospective study from a tertiary care centre at Northern India. Patients with HIV/AIDS infection (PLHA) presenting with signs and symptoms of tuberculosis, diagnosed as cases of tuberculosis (pulmonary and extra pulmonary) were evaluated with respect to clinical profile, disease characteristics and socio demographic profile and respective data collected. 132 patients with HIV/AIDS infection diagnosed as cases of tuberculosis were included in study and data evaluated. Common clinical features included fever (84.4%), weight loss, (81.8%), cough with hemoptysis, followed by headache and altered sensorium. CD4 count <250 was significantly associated with tubercular infection with males effected more than females. Patients were diagnosed as having tubercular infection by AFB staining, Non-resolving pneumonitis on chest X-ray, HRTCT chest besides sputum culture, ESR, Monteux test, FNAC of lymph nodes and CSF study in extra pulmonary tubercular patients. The disease burden is more in developing and underdeveloped nations with high incidence of human immunodeficiency virus infection. Individuals infected with HIV infection may develop tubercular infection in course of HIV disease or may present with signs and symptoms of tubercular infection before being diagnosed as having HIV infection. The incidence of tubercular co-infection in PLHA is directly influenced by CD4 count and increases with fall in CD4 count. High degree of clinical suspicion with prompt evaluation for secondary infection including tuberculosis and timely management is associated with better outcomes.

Keywords


HIV/AIDS, tuberculosis, morbidity, mortality, treatment

References