Clinical and Laboratory Profile of Sputum Positive Pulmonary Tuberculosis Among HIV Seropositive and HIV Seronegative Patients – A Cross Sectional Study

Abstract

Background and objectives ABSTRACT Tuberculosis continues to be the most important cause of morbidity and mortality worldwide, killing approximately two million people each year. The pattern of clinical presentation of TB is reflected in the microbiological and radiological characteristics of the disease. However coinfection with human immunodeficiency virus ( HIV ) poses special diagnostic and therapeutic challenges. The objective of the present study was to assess the clinical and laboratory profile of sputum positive pulmonary tuberculosis among HIV seropositive and HIV seronegative patients. Methodology Present one year cross sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum on 104 patients with sputum positive pulmonary tuberculosis patients during the period of January 2009 to December 2009. Routine investigations, haemogram, sputum smears for AFB, chest X-ray were done. Results Seroprevalence of HIV among pulmonary tuberculosis patients was 23.08% with male predominance ( 79.17% ) and highest ( 50% ) in the age group of 31 to 40 years. The most common symptom was cough with expectoration ( 100% ) . Fever ( 95.83% ) , weight loss ( 83.33% ) , loss of appetite ( 70.83% ) and diarrhoea ( 12.50% ) were more common among HIV seropositives compared to HIV seronegatives. On examination, anaemia, undernourishment, V lymphadenopathy and the presence of opportunistic infections like oral candidiasis ( 66.67% ) , herpes zoster scar ( 50% ) and genital lesions ( 16.67% ) were more common among HIV seropositives compared to HIV seronegatives. Chest X-ray findings showed, cavitation, fibrosis and fibrocavitatory lesions predominantly among HIV seronegatives while infiltration and miliary mottling was seen in HIV seropositives. Upper zone infiltration, cavitation and fibrosis were more commonly involved among HIV seronegatives compared to HIV seropositives. Conclusion Clinical and laboratory presentation varied among HIV seropositives and HIV seronegatives and presence of opportunistic infections may assist in identifying PTB patients with HIV infection.