Indian Journal of Dermatology, Venereology and Leprology
Medknow Publications on behalf of The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL)
Vol. 72, No. 4, 2006, pp. 276-282
Bioline Code: dv06095
Full paper language: English
Document type: Research Article
Document available free of charge
Indian Journal of Dermatology, Venereology and Leprology, Vol. 72, No. 4, 2006, pp. 276-282
© Copyright 2006 Indian Journal of Dermatology, Venereology and Leprology.
HIV and tuberculosis: Partners in crime|
Maniar JanakK, Kamath RatnakarR, Mandalia Sundhiya, Shah Keyur, Maniar Alok
Background: Tuberculosis is the commonest infection detected in HIV-infected individuals worldwide.
Aim: The aim of this study is to describe the clinical, bacteriologic and radiological spectrum of tuberculosis (TB) in the setting of human immunodeficiency virus (HIV) infection in a tertiary care centre in Mumbai.
Methods: A total of 8640 HIV-infected individuals were screened for tuberculosis routinely from January 1998 to December 2003, using clinical examination, chest X-ray and abdominal ultrasonography, sputum smears for acid-fast bacilli (AFB) and culture on Lowenstein-Jensen medium.
Results: TB was detected in 8078 (93.5%) patients of whom 3393 (42%) had pulmonary, 3514 (43.5%) had extrapulmonary TB and 1171 (14.5%) had disseminated disease. One thousand two hundred thirty eight patients (36.5%) showed AFB in sputum, while 1154 (34%) showed growth on culture medium and 4174 had radiographic involvement. In 781 (67%) individuals disseminated disease coexisted with pulmonary involvement. All 8078 coinfected patients were treated with anti-TB therapy (ATT), of whom 6422 patients (79.5%) showed one or more adverse events. Gastritis was the commonest complaint followed by hepatitis and skin rashes. ATT resistance was detected in 482 individuals.
Conclusion: Tuberculosis is the commonest opportunistic infection (OI) in HIV positive patients in India, showing a higher prevalence of extrapulmonary and disseminated TB and adverse events due to ATT. Early recognition of concurrent OIs and their adequate treatment and prophylaxis is essential.
HIV, Tuberculosis, Coinfection, Spectrum, Antituberculous therapy
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