Abstract

PROSPECTIVE STUDY OF TUBERCULAR MANIFESTATION IN HIV POSITIVE PATIENTS IN VIMSAR, BURLA, SAMBALPUR, ODISHA

Author(s): Prafulla Kumar Bariha, Ashok Kumar Behera, Umesh Prasad Pujari

BACKGROUND Tuberculosis is the commonest opportunistic infection in HIV positive patient. This is a major challenge faced by HIV positive patient. There are less number of studies in India. MATERIALS AND METHODS This study was carried out at Medicine Department and ART Centre, VIMSAR, Burla to know the epidemiology and clinical profile of HIV and TB co-infection. This is a prospective study in which all adult patients attending our hospital for period of one year with HIV-TB co infection were enrolled. There were 269 patients. The clinical parameters were studied after all detailed history and clinical examination. The diagnosis of tuberculosis was made by relevant investigation like Sputum AFB, Chest X-ray, CSF Study, CT Scan, Pleural Fluid Study, Ascitic fluid study etc. RESULTS The data were compiled. Majority of the patients, out of 211 patients, 74 (82.52%) were male, 34 (16.35%) were female & TGTS were-3 (1.42%). Age group mostly affected were 26-35 years (38.1 %) and 36-45 years (38.1%). Extra-pulmonary TB constituted 56.28% and Pulmonary TB-43.72%. 41.99% completed anti-TB treatment and mortality was 12.99%. Mean CD4 count at the time of diagnosis-218; and patients with low CD4 count at the time of diagnosis had high mortality. Extra-pulmonary TB is predominant among HIV TB co-infection and the working-class population. A low CD4 count at the time of tuberculosis diagnosis is associated with a higher mortality and early suspicion diagnosis of tuberculosis and early initiation of ATT in HIV patients reduces mortality and morbidity significantly. CONCLUSION Tubercular Co-infection- It most commonly affects the younger economically productive sexually active section of the society. CD4 cell count were inversely related to Tubercular infection in HIV patients. Decrease in CD4 cell count points to increase in Tubercular infection. Males are commonly affected compared to female. Extra-pulmonary tuberculosis is common compared to Pulmonary Tuberculosis.