TB disease patterns by HIV and diabetes status
Summary
Extrapulmonary tuberculosis (EPTB) is more common than previously thought, even without HIV or diabetes. HIV increases EPTB risk, while diabetes favors pulmonary TB (PTB), highlighting the need for better TB classification.
Area of Science:
- Medical research
- Infectious diseases
- Public health
Background:
- Tuberculosis (TB) is typically classified as pulmonary TB (PTB) or extrapulmonary TB (EPTB).
- Understanding TB disease patterns and risk factors requires further investigation.
- Existing classifications may not fully capture the spectrum of TB presentation.
Purpose of the Study:
- To refine case definitions for PTB, EPTB, and concurrent PTB + EPTB.
- To analyze TB disease patterns based on HIV and diabetes mellitus (DM) status.
- To assess the prevalence of EPTB in diverse patient populations.
Main Methods:
- Prospective cohort study involving Indian patients with presumed TB.
- Utilized point-of-care ultrasound (POCUS) for clinical and imaging data collection.
- Categorized patients into HIV-positive/negative and DM-positive/negative groups.
Main Results:
- In HIV-/DM- patients, 52% had any EPTB.
- In HIV+/DM- patients, a significant 94% had EPTB.
- In HIV-/DM+ patients, 39% had EPTB, with a higher proportion of PTB.
Conclusions:
- Refined case definitions show substantial EPTB prevalence, even without comorbidities.
- HIV status is associated with an increased likelihood of EPTB.
- Diabetes mellitus is linked to a higher incidence of PTB.
- The PTB/EPTB dichotomy is insufficient; EPTB warrants greater research and clinical focus.
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