RESEARCH PAPER
Clinico-pathological profile of patients with HIV and tuberculosis co-infection
 
More details
Hide details
1
Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, India
 
 
Submission date: 2022-08-26
 
 
Final revision date: 2023-02-20
 
 
Acceptance date: 2023-08-02
 
 
Online publication date: 2024-09-20
 
 
Corresponding author
Sinchana KM   

Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576 104, India, e-mail: sinchanagowda02@gmail.com
 
 
HIV & AIDS Review 2024;23(3)
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Human immunodeficiency virus (HIV) and tuberculosis (TB) are two main leading global causes of mortality and morbidity. TB and HIV increase progressive deterioration of immunological functions by speeding progression of one another.

Material and methods:
The present 5-year retrospective study was carried out in the Department of Pathology at a tertiary care hospital in South India. Study included clinico-pathological profile of 80 people living with HIV (PLHIV) and subsequently developed TB co-infection; their CD4+ counts done at the time of admission were examined.

Results:
The present study included 80 HIV-TB co-infected cases. The age of the patients ranged from 18 to 65 years. The mean CD4+ T lymphocyte count was 164.7 cells/μl. Pulmonary TB was diagnosed in 59 patients (73.8%), while extra-pulmonary TB was detected in 21 (26.2%) cases. Abdominal TB was the most common site among extra-pulmonary TB cases. Opportunistic infections (OIs) other than TB, included 2 cases with oral candidiasis and 1 case with central nervous system (CNS) toxoplasmosis. Two of the HIV-TB co-infected cases were subsequently diagnosed with primary CNS (n = 1) and retroperitoneal lymphoma (n = 1).

Conclusions:
In the present study, HIV-TB co-infection is more common in 25-50 years age group. Antiretroviral therapy has changed the nature of disease from fatal to chronic condition. OIs other than TB and neoplasms reported in our study included oral candidiasis, CNS toxoplasmosis, and lymphoma. PLHIV with low CD4+ count require close monitoring, adequate counselling, and further evaluation for atypical presentation of TB, OIs, and neoplasms to improve their outcomes.

 
REFERENCES (20)
1.
Sharma SK, Kadhiravan T, Banga A, Goyal T, Bhatia I, Saha PK. Spectrum of clinical disease in a series of 135 hospitalised HIV-infected patients from north India. BMC Infect Dis 2004; 4: 52-58.
 
2.
Bruchfeld J, Correia-Neves M, Källenius G. Tuberculosis and HIV coinfection. Cold Spring Harb Perspect Med 2015; 5: a017871. DOI: 10.1101/cshperspect.a017871.
 
3.
Mohan A, Harikrishna J, Kumar DP, Kumar ND, Sharma PS, Kumar BS, et al. Provider-initiated HIV testing & counselling in incident tuberculosis cases under National TB Programme conditions at a tertiary care teaching hospital in Tirupati, south India. Indian J Med Res 2017; 146: 774-779.
 
4.
Solomon FB, Angore BN, Koyra HC, Tufa EG, Berheto TM, Admasu M. Spectrum of opportunistic infections and associated factors among people living with HIV/AIDS in the era of highly active anti-retroviral treatment in Dawro Zone hospital: a retrospective study. BMC Res Notes 2018; 11: 604. DOI: 10.1186/s13104-018-3707-9.
 
5.
TB India. RNTCP status report. Available from: http://wwwtbcindiaorg/pdfs/TB%....
 
6.
WHO/TB/96.200 (SEA). A Clinical Manual for Southeast Asia. Geneva: World Health Organization; 1996.
 
7.
Silveira-Mattos PS, Barreto-Duarte B, Vasconcelos B, Fukutani KF, Vinhaes CL, Oliveira-de-Souza D. Differential expression of activation markers by Mycobacterium tuberculosis-specific CD4+ T cell distinguishes extrapulmonary from pulmonary tuberculosis and latent infection. Clin Infect Dis 2020; 71: 1905-1911.
 
8.
Patel AK, Thakrar SJ, Ghanchi FD. Clinical and laboratory profile of patients with TB/HIV coinfection: s case series of 50 patients. Lung India 2011; 28: 93-96.
 
9.
World Health Organization (WHO). Tuberculosis. Available from: https://www.who.int/news room/fact sheets/detail/tuberculosis.
 
10.
Kamath R, Sharma V, Pattanshetty S, Hegde MB, Chandrasekaran V. HIV-TB coinfection: clinic-epidemiological determinants at an antiretroviral therapy center in Southern India. Lung India 2013; 30: 302-306.
 
11.
Tiewsoh JB, Antony B, Boloor R. HIV-TB co-infection with clinical presentation, diagnosis, treatment, outcome and its relation to CD4 count, a cross-sectional study in a tertiary care hospital in coastal Karnataka. J Family Med Prim Care 2020; 9: 1160-1165.
 
12.
Kerkhoff D, Meintjes G, Opie J, Vogt M, Jhilmeet N, Wood R, et al. Patients with HIV-associated TB: relative contributions of anaemia of chronic disease and iron deficiency. Int J Tuberc Lung Dis 2016; 20: 193-201.
 
13.
Shastri S, Naik B, Shet A, Rewari B, Costa AD. TB treatment outcomes among TB-HIV co-infections in Karnataka, India: how do these compare with non-HIV tuberculosis outcomes in the province? BMC Public Health 2013; 13: 838. DOI: 10.1186/1471-2458-13-838.
 
14.
Sharma SK, Ryan H, Khaparde S, Sachdeva KS, Singh AD, Mohan A, et al. Index-TB guidelines: guidelines on extrapulmonary tuberculosis for India. Indian J Med Res 2017; 145: 448-463.
 
15.
Antwal M, Gurjar R, Chidrawar S, Pawar J, Gaikwad S, Panchal N, et al. Clinical profile of HIV infected patients attending a HIV referral clinic in Pune, India. Indian J Med Res 2014; 140: 271-277.
 
16.
Agarwal D, Narayan S, Chakravarty J, Sundar S. Ultrasonography for diagnosis of abdominal tuberculosis in HIV infected people. Indian J Med Res 2010; 132: 77-80.
 
17.
Naidoo K, Rampersad S, Karim SA. Improving survival with tuberculosis & HIV treatment integration: a mini-review. Indian J Med Res 2019; 150: 131-138.
 
18.
Das PP, Saikia L, Nath R, Phukan SK. Species distribution & anti­fungal susceptibility pattern of oropharyngeal Candida isolates from human immunodeficiency virus infected Individuals. Indian J Med Res 2016; 143: 495-501.
 
19.
Saha K, Firdaus R, Santra P, Pal J, Roy A, Bhattacharya MK, et al. Recent pattern of co-infection amongst HIV seropositive individuals in tertiary care hospital, Kolkata. Virol J 2011; 8: 116. DOI: 10.1186/1743-422X-8-116.
 
20.
Akinyemi JO, Ogunbosi BO, Fayemiwo AS, Adesina OA, Obaro M, Kuti MA, et al. Demographic and epidemiological characteristics of HIV opportunistic infections among older adults in Nigeria. Afr Health Sci 2017; 17: 315-321.
 
eISSN:1732-2707
ISSN:1730-1270
Journals System - logo
Scroll to top