SPECTRUM OF PULMONARY TUBERCULOSIS IN HIV POSITIVE PATIENTS WITH SPECIAL REFERENCE TO CD4 COUNTS.

H.O.Gupta; R.Patel; Rakesh Tikadar

Volume : VIII, Issue : X, October - 2019

SPECTRUM OF PULMONARY TUBERCULOSIS IN HIV POSITIVE PATIENTS WITH SPECIAL REFERENCE TO CD4 COUNTS.

H. O. Gupta, R. Patel, Rakesh Tikadar

Abstract :

INTRODUCTION: Tuberculosis is one of the commonest opportunistic infections in HIV positive patient. Person with HIV is upto–30 times more likely to develop active TB than normal individual. OBJECTIVE: To evaluate the spectrum of PTB in HIV patients, CD4 count in PTB of HIV patients, how CD4 count affect the PTB in patients. MATERIAL AND METHODE: This is a PROSPECTIVE OBSERVATIONAL STUDY of 150 patients with age >15 year. Inclusion Criteria: All HIV positive patients with sputum positive or sputum negative PTB. Exclusion criteria: All extrapulmonary tuberculosis. RESULTS: Middle aged 26–45years (68%) individual are most commonly affected especially the rural population (84.7%). The population which are more commonly affected is the low education status individuals (primary and high school each of 35%) but among the female uneducated group are more common. Most common mode of transmission in decreasing order are sexual (75%), blood and its product (21%), IVD users (4%). Most common symptoms are cough (93%), weight loss (81%), fever (67%). Out of 150 patients, 15% are sputum AFB positive and 45% are CBNAAT positive. In patients with CD4 count below 200, atypical involvement (bilateral, lower lobe, consolidation and miliary mottling) is more common than typical (apical region, cavitary lesion) involvement. Conclusion: There is a need for better diagnostic test to detect PTB other than sputum smear examination in HIV patient especially among CD4<200. CXR remains an important diagnostic tool for PTB in HIV patients, but in patient with CD4<200 atypical involvement of lung is common (lower zone, b/l, consolidation) than typical involvement (apical lobe, cavitary lesion). So it is necessary for the accurate and timely diagnosis of tuberculosis in HIV patient with CD4<200 sputum smear negative and atypical lung involvement