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结核病/艾滋病病毒合并感染患者的临床和实验室特征:50例病例系列研究

Clinical and laboratory profile of patients with TB/HIV coinfection: A case series of 50 patients.

作者信息

Patel Anand K, Thakrar Sandip J, Ghanchi Feroz D

机构信息

Department of Pulmonary Medicine, S.B.K.S. Medical Institute and Research Centre, Sumandeep Vidhyapeeth University, Piparia, Vadodara, Gujarat, India.

出版信息

Lung India. 2011 Apr;28(2):93-6. doi: 10.4103/0970-2113.80316.

Abstract

BACKGROUND

Tuberculosis (TB) is said to be one of the commonest opportunistic infection in patients with HIV/AIDS.

OBJECTIVE

To study the clinical and laboratory profile of patients with HIV/TB coinfection.

MATERIALS AND METHODS

Fifty adult TB patients having confirmed HIV seropositivity were included in randomized manner. A detailed history and thorough physical examination was done. Laboratory and radiological investigations were carried out as appropriately warranted.

RESULTS

Most of the patients were farm workers (30%) followed by manual laborers (22%) and transport drivers (16%). Heterosexual route was found in 86% of patients. Cough was present in 94% while fever and weight loss in 86% and 78% of patients, respectively. Out of 50 patients, 40% had only pulmonary TB (PTB), 46% had pulmonary and extra-pulmonary TB (EPTB), 10% had only EPTB and 4% had multisystemic EPTB. Mediastinal lymphadenopathy was present in 34% while pleural effusion and extra-thoracic lymph nodes was present in 20% and 18% of patients, respectively. Positive smear for acid-fast bacilli (AFB) was found in 25.58% while positive Mantoux test was found in 32.14% of patients.

CONCLUSION

HIV/TB coinfection is more common in sexually active age group and commonest mode of HIV infection is heterosexual transfer. Sputum smear AFB and Mantoux test positivity is low in TB patients having HIV. Disseminated TB is common in HIV. Mediastinal lymphadenopathy is common site among extra-pulmonary tuberculosis.

摘要

背景

结核病据说是艾滋病毒/艾滋病患者中最常见的机会性感染之一。

目的

研究艾滋病毒/结核病合并感染患者的临床和实验室特征。

材料与方法

随机纳入50例确诊为艾滋病毒血清阳性的成年结核病患者。进行了详细的病史询问和全面的体格检查。根据需要进行了实验室和影像学检查。

结果

大多数患者是农场工人(30%),其次是体力劳动者(22%)和运输司机(16%)。86%的患者通过异性传播途径感染艾滋病毒。94%的患者有咳嗽症状,86%和78%的患者分别有发热和体重减轻症状。50例患者中,40%仅患有肺结核(PTB),46%患有肺结核和肺外结核(EPTB),10%仅患有EPTB,4%患有多系统EPTB。34%的患者有纵隔淋巴结肿大,20%和18%的患者分别有胸腔积液和胸外淋巴结肿大。25.58%的患者痰涂片抗酸杆菌(AFB)阳性,32.14%的患者结核菌素试验阳性。

结论

艾滋病毒/结核病合并感染在性活跃年龄组中更为常见,艾滋病毒感染最常见的方式是异性传播。艾滋病毒感染的结核病患者痰涂片AFB和结核菌素试验阳性率较低。播散性结核病在艾滋病毒感染者中很常见。纵隔淋巴结肿大是肺外结核的常见部位。

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