[Tuberculosis in human immunodeficiency virus infection. 22 cases]

Area of Science:

• Infectious Diseases
• Public Health
• Immunology

Context:

• Retrospective analysis of 22 tuberculosis (TB) cases in HIV-1 positive patients in Marseille, France.
• High prevalence area for Human Immunodeficiency Virus (HIV) infection.
• Significant proportion of patients were intravenous drug users (67%) and had Acquired Immunodeficiency Syndrome (AIDS) prior to TB diagnosis (32%).

Purpose:

• To document and analyze the clinical presentation, treatment response, and outcomes of tuberculosis in HIV-1 positive patients in a specific French region.
• To compare findings with studies from other geographical areas, particularly the United States.
• To explore potential factors influencing observed epidemiological differences.

Summary:

• M. tuberculosis was isolated from bronchopulmonary samples in nearly all patients.
• Pulmonary tuberculosis frequently presented with excavated lesions (5/10 with radiological abnormalities).
• Extrathoracic involvement was infrequent (4 cervical adenopathies, 4 asymptomatic extra-pulmonary sites).
• All patients responded to chemotherapy with no relapses.
• Mortality was primarily due to AIDS complications within two years post-TB diagnosis.

Impact:

• Findings suggest unique epidemiological characteristics of TB in HIV-1 positive individuals in this French cohort.
• Observed differences in TB presentation (e.g., high frequency of excavated pulmonary lesions, later onset) may be influenced by local factors.
• Potential impact of childhood BCG vaccination on TB epidemiology in HIV-1 positive populations warrants further investigation.