A COMPARATIVE STUDY OF CLINICO-RADIOLOGICAL FINDING OF PULMONARY TUBERCULOSIS AMONG HIV SERO-POSITIVE WITH HIV SERO-NEGATIVE PATIENTS

Dr. Mahendra Kumar Bainara; Dr Prem Chand; Dr. Neha Damor

Volume : VII, Issue : VII, July - 2018

A COMPARATIVE STUDY OF CLINICO-RADIOLOGICAL FINDING OF PULMONARY TUBERCULOSIS AMONG HIV SERO-POSITIVE WITH HIV SERO-NEGATIVE PATIENTS

Dr. Mahendra Kumar Bainara, Dr Prem Chand, Dr. Neha Damor

Abstract :

BACKGROUND:WHO estimated burden of tuberculosis in HIV among estimated incident TB patients was 5.0% (4.5%– 5.4%) in India.Diagnosis of tuberculosis among HIV infected persons is often delayed, and is difficult to make since HIV–infected persons with tuberculosis are more likely to have negative sputum smears and minor or non–specific X–ray abnormalities. AIM: To compare clinical and radiological finding between HIV seropositive and HIV seronegative new pulmonary tuberculosis cases. METHOD:This was a prospective study conducted in the department of Respiratory Medicine,R.N.T.Medical College, Udaipur, Rajasthan on total 100 new pulmonary tuberculosis cases consisting 50 HIV seropositive and 50 HIV seronegative, above age of 15 years.Blood investigations, CD4 count, chest x–ray, sputum examination for AFB, sputum / BAL for CBNAAT was performed (in sputum smear negative cases and all HIV seropositive cases).RESULTS: Majority were in age group of 20–39years (54%) and with male predominance. Cough was the predominant respiratory symptom in both groups followed by expectoration, Dyspnoea, chest pain and blood in sputum. Chest pain was more common in HIV seropositive(52%vs 18%). Fever was more common in HIV seronegative (96%) PTB as compared with HIV seropositive( 82% )whereas weight loss, weakness and anorexia was more common in HIV seropositive PTB cases. Lymphadenopathy,pallor,edema and oral thrush were more common in HIV seropositive PTB cases.Most of the study subjects had moderate to far advanced disease and bilateral radiological involvement. Mid and lower zone involvement was more in HIV seropositive PTB cases(76%vs46%). Infiltration was the most common presentation seen both in HIV seropositive and HIV seronegative PTB. Consolidation was significantly more common in HIV seronegative PTB cases .Cavity was present only in 8% HIV seropositive and 20% seronegative PTB cases. Other presentation wasinfiltration with hilar enlargement, infiltration with pleural effusion, military mottling.CONCLUSION:Clinico–radiological presentation of pulmonary TB differs between HIV–seropositive and HIV–seronegative patients due to progressive immunodeficiency from HIV infection.