Tiewsoh Jutang Babat Ain, Antony Beena, Boloor Rekha
Department of Microbiology, Fr. Muller Medical College, Kankanady, Mangalore, Karnataka, India.
J Family Med Prim Care. 2020 Feb 28;9(2):1160-1165. doi: 10.4103/jfmpc.jfmpc_950_19. eCollection 2020 Feb.
Tuberculosis (TB) is the leading killer and the commonest opportunistic infection (OI) in human immunodeficiency virus (HIV) infected individuals with 0.3 million deaths in 2017. When HIV and TB co-infection occurs, they form a deadly combination with each accelerating the progression of the other, resulting in increased morbidity and mortality.
To study the demographic pattern, clinical presentation, opportunistic infections, radiological and laboratory profile, management, and outcome of HIV-TB coinfected individuals.
A prospective cross-sectional study was carried out on confirmed HIV cases already diagnosed with TB and those newly detected with TB after admission, where diagnosis was carried out following standard operative procedures.
In our study of 58 HIV-TB co-infected individuals, 40-50 years was the most common age group affected. Males were affected more with majority being married. The most common presentation was fever (67%) followed by gastrointestinal symptoms. Majority of TB cases were newly diagnosed (65.5%), with predominance of pulmonary tuberculosis (PTB) ( = 35) followed by those having only extrapulmonary tuberculosis (EPTB) ( = 12) and both ( = 11). TB was diagnosed by microscopy in 32.7%, while radiologically, chest X-ray was most common (36.2%). Also, 50% were infected with other OIs where oral candidiasis was the most common (37.93%). The overall mean CD4 count was 220 cells/μL and those with EPTB had lesser CD4 counts than those with PTB. All were on DOTS regimen and majority showed improvement.
In a country like India where both these diseases are rampant, we recommend better information, education, understanding and awareness for prevention, care, early diagnosis, and treatment of these two notorious infectious diseases with prevention of relapse and default of TB cases in HIV-TB co-infected individuals a priority.
结核病（TB）是人类免疫缺陷病毒（HIV）感染者的主要死因和最常见的机会性感染（OI），2017年有30万人死亡。当HIV与结核病合并感染时，它们形成致命组合，相互加速对方的进展，导致发病率和死亡率增加。
研究HIV-结核病合并感染个体的人口统计学模式、临床表现、机会性感染、放射学和实验室检查结果、治疗及转归。
对已确诊患有结核病的HIV确诊病例以及入院后新检测出结核病的病例进行前瞻性横断面研究，诊断按照标准操作程序进行。
在我们对58例HIV-结核病合并感染个体的研究中，40至50岁是受影响最常见的年龄组。男性受影响更多，大多数已婚。最常见的表现是发热（67%），其次是胃肠道症状。大多数结核病病例是新诊断的（65.5%），以肺结核（PTB）为主（=35），其次是仅有肺外结核（EPTB）的病例（=12）和两者皆有的病例（=11）。32.7%的结核病通过显微镜检查确诊，而在放射学检查中，胸部X线最常见（36.2%）。此外，50%的患者感染了其他机会性感染，其中口腔念珠菌病最常见（37.93%）。总体平均CD4细胞计数为220个/μL，EPTB患者的CD4细胞计数低于PTB患者。所有患者均采用直接观察短程治疗（DOTS）方案，大多数患者病情有所改善。
在像印度这样这两种疾病猖獗的国家，我们建议加强信息、教育、理解和认识，以预防、护理、早期诊断和治疗这两种臭名昭著的传染病，将预防HIV-结核病合并感染个体的结核病复发和治疗中断作为优先事项。
