Kassu Afework, Mengistu Getahun, Ayele Belete, Diro Ermias, Mekonnen Firew, Ketema Dereje, Moges Feleke, Mesfin Tsehay, Getachew Assefa, Ergicho Bahiru, Elias Daniel, Aseffa Abraham, Wondmikun Yared, Ota Fusao
Department of Microbiology and Parasitology, University of Gondar, Gondar, Ethiopia.
J Microbiol Immunol Infect. 2007 Apr;40(2):116-22.
The pattern of clinical presentations of tuberculosis (TB) is reflected in the microbiological, radiological, and histological characteristics of the disease. However, coinfection with human immunodeficiency virus (HIV) poses special diagnostic and therapeutic challenges. This study was aimed at assessing the clinical manifestations of TB in patients with or without HIV coinfection in a hospital-based cross-sectional study in Gondar, Ethiopia.
TB was diagnosed following standard clinical, bacteriological, radiological, and histological procedures. HIV serostatus was checked by enzyme-linked immunosorbent assay.
This study included 257 TB patients, of whom 52.1% were coinfected with HIV. Pulmonary TB and extrapulmonary TB were diagnosed in 64.2% and 35.8% of the patients, respectively. No significant association was found between sputum smear positivity and HIV serostatus. One-fifth of the patients reported hemoptysis. More than one-third had chest pain, and >90% reported fever and weight loss. Night sweats and cough were reported by 86% and 82.5%, respectively. Coarse crepitations were the most frequent auscultatory finding (33.9%). Sputum smear positivity rate was 26.8%. Cavitation was significantly associated with sputum smear positivity (odds ratio = 9.0, 95% confidence interval = 2.4-34.1). Wasting, cough of <or=5 months' duration, crepitation, chronic diarrhea, and herpes zoster scar were significantly associated with HIV-positive serology.
Coinfection with HIV was very high in patients with TB. The presence of herpes zoster scar, chronic diarrhea, coarse crepitations, and cough of <or=5 months' duration may assist in identifying TB patients with HIV infection.
结核病（TB）的临床表现模式体现在该疾病的微生物学、放射学及组织学特征中。然而，合并人类免疫缺陷病毒（HIV）感染带来了特殊的诊断和治疗挑战。本研究旨在通过在埃塞俄比亚贡德尔进行的一项基于医院的横断面研究，评估合并或未合并HIV感染的结核病患者的临床表现。
按照标准的临床、细菌学、放射学及组织学程序诊断结核病。通过酶联免疫吸附测定法检查HIV血清学状态。
本研究纳入了257例结核病患者，其中52.1%合并HIV感染。分别有64.2%和35.8%的患者被诊断为肺结核和肺外结核。痰涂片阳性与HIV血清学状态之间未发现显著关联。五分之一的患者报告有咯血。超过三分之一的患者有胸痛，超过90%的患者报告有发热和体重减轻。分别有86%和82.5%的患者报告有盗汗和咳嗽。粗湿啰音是最常见的听诊发现（33.9%）。痰涂片阳性率为26.8%。空洞形成与痰涂片阳性显著相关（比值比 = 9.0，95%置信区间 = 2.4 - 34.1）。消瘦、持续时间≤5个月的咳嗽、湿啰音、慢性腹泻及带状疱疹瘢痕与HIV血清学阳性显著相关。
结核病患者中合并HIV感染的比例很高。带状疱疹瘢痕、慢性腹泻、粗湿啰音及持续时间≤5个月的咳嗽可能有助于识别合并HIV感染结核病患者。
