Clinical Spectrum of Pulmonary Tuberculosis in HIV Patients

HIV and TB coinfection is now the greatest health challenge to mankind. Numerous studies have detailed the effect of HIV infection on the clinical profile of pulmonary TB.

To study the clinical spectrum of Pulmonary Tuberculosis in HIV patients.

It is a Cross Sectional Study. Study Period is from January 2013 to March 2014. Study place is Sree Mookambika Institute of Medical Sciences, Kulasekharam, District Kanyakumari, Tamil Nadu. Sample Size = 4PQ/d². 60 cases of bacteriologically, radiologically and/or histopathologically confirmed pulmonary tuberculosis patients with HIV infection diagnosed by ELISA method were included in the study. Routine history was taken and a detailed clinical examination was done. Statistical test used is chi square test.

An overwhelming 95% of patients were between 21 and 40 years of age. The commonest symptom was cough present in 58(96.66%) patients. Anorexia and weight loss was seen in 47(78.33%) and 45(75%) of patients respectively. Bronchial breathing was heard in 19(31.6%) patients while crepitations were seen in 50(83.3%) patients. Associated pleural effusion was seen in 15(25%) patients. Sputum was positive for AFB in 28(46.66%) and there were 32(53.33%) sputum negative cases. Commonest radiological lesion was ill-defined exudative/infiltrative lesion seen in 44(73.33%) patients. Middle zones were commonly involved in about 76.6% patients.

Clinical profile of pulmonary tuberculosis in HIV positive cases varies depending on immune status of the individual. With worsening immune status, the classic presentation become uncommon and is replaced by atypical clinical and radiological patterns that can make diagnosis challenging and difficult.