HIV and tuberculosis: partners in crime

Area of Science:

• Infectious Diseases
• Public Health
• Clinical Medicine

Background:

• Tuberculosis (TB) is the most common infection in individuals with human immunodeficiency virus (HIV) globally.
• HIV-infected individuals are at a significantly higher risk for developing TB, underscoring the importance of co-infection management.

Purpose of the Study:

• To characterize the clinical, bacteriologic, and radiological spectrum of TB in HIV-infected patients.
• To identify the prevalence of different forms of TB (pulmonary, extrapulmonary, disseminated) in this population.
• To document adverse events associated with anti-TB therapy (ATT) in coinfected individuals.

Main Methods:

• Screening of 8640 HIV-infected individuals for TB over a five-year period (January 1998 - December 2003).
• Utilized clinical examination, chest X-ray, abdominal ultrasonography, sputum smear microscopy for acid-fast bacilli (AFB), and Lowenstein-Jensen culture for diagnosis.
• Data collection on patient demographics, TB classification, diagnostic findings, treatment outcomes, and adverse events.

Main Results:

• Tuberculosis was detected in 93.5% of screened HIV-infected individuals.
• Extrapulmonary (43.5%) and disseminated (14.5%) TB were highly prevalent, often coexisting with pulmonary involvement (42%).
• Over 79% of patients experienced adverse events from ATT, with gastritis being the most common, and ATT resistance noted in 482 individuals.

Conclusions:

• Tuberculosis is the leading opportunistic infection in HIV-positive patients in India.
• The study indicates a higher incidence of extrapulmonary and disseminated TB, along with increased adverse events from ATT in this cohort.
• Prompt identification and management of opportunistic infections, including TB, and prophylaxis are crucial for improving outcomes in HIV-infected individuals.