The prevalence of urogenital tuberculosis in people living with HIV

The prevalence of urogenital tuberculosis (UGT) is not well known, especially in people living with HIV, therefore, our aim was to identify the prevalence of urogenital tuberculosis in HIV-infected individuals and characterize the clinical and laboratory risk factors associated with UGT. A cross sectional study was conducted to characterize the prevalence of UGT in people living with HIV. PCR tests and specific culture were performed on samples from 181 patients living with HIV, divided into two groups: A) patients with suggestive UGT symptoms and b) hospitalized patients without any suggestive UGT symptoms. Only one case of UGT was diagnosed, with a positive PCR but negative specific culture, resulting in a prevalence of 0.55%. The patient had disseminated tuberculosis (miliary pulmonary, intestinal, and urogenital with bilateral nephromegaly) with acute febrile syndrome, no urogenital symptoms, but with microscopic hematuria and sterile pyuria. This patient had poorly controlled HIV infection with positive viral load and CD4 count below 200 cells/mm³. The prevalence of UGT in patients living with HIV is very low. However, patients with poorly controlled disease may present disseminated tuberculosis associated with UGT. Urine screening for UGT may be relevant for diagnosing disseminated tuberculosis in patients living with HIV with acute infectious syndrome.