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[A clinical research on human immunodeficiency virus seropositive patients with pulmonary tuberculosis]
1Department of Infectious Diseases, Dongguan People's Hospital, Guangdong Province, Dongguan 523000, China.
Objective:
To improve the awareness of human immunodeficiency virus (HIV) infection in patients with pulmonary tuberculosis (PTB).
Methods:
168 cases of HIV-positive PTB in Bata Regional Hospital, Guinea Equatorial from January 1996 to November 1999 were analyzed.
Results:
HIV seroprevalence rose from 11.4% in 1996 to 22.7% in 1999. Analysis of clinical findings showed that majority of the cases showed acute onset (94.6%). Recent weight loss (82.1%), joints pain (78.6%), skin itching (42.9%), chronic diarrhea (23.2%), generalized lymphadenopathy (20.8%) and dermatosis (13.1%) were the frequent symptoms and signs. The chest X-rays showed that the atypical radiographic patterns (63.3%). The positive rate of sputum for acid fast bacilli was 58.3%. At the end of six months of antituberculosis chemotherapy (2SHRZ/4HRZ), all of the survival patients improved in the clinical symptoms and signs, and laboratory and X-rays. The mortality rate was significantly higher in HIV-positive PTB (27.4%) patients than in HIV-negative patients (9.2%).
Conclusions:
Physician should be alert of the occurrence of HIV-associated PTB. Direct smear examination of sputum and chest X-rays are the best methods for the rapid and correct diagnosis. Short-course chemotherapy of 6 months is as effective in HIV-positive patients as in HIV-negative patients.