Title: To Study the Relationship between HIV Infection and Tubercular Manifestation with Level of Immunosuppresion and Duration of Illness
Authors: Shoaib Mehboob, T.P. Singh, Prashant Prakash, Abhishek Raj
DOI: https://dx.doi.org/10.18535/jmscr/v8i3.84
Abstract
Introduction: Mycobacterium tuberculosis infection is one of the most common opportunistic infection associated with HIV in India.It is estimated that nearly 60 – 70% of HIV positive individuals will develop tubercular infection in their lifetime. It is one of the leading causes of death in HIV infected individuals. Manifestation of tuberculosis infection are extremely variable in HIV infected individuals and depends upon the level of immunosuppression and duration of illness. Around 1.8 million new cases of tuberculosis occur annually in India and similarly the estimated pool of HIV infection is approximately 2.5 million. Therefore there is always increased risk of synergistic interaction between the two diseases.
Objective: To study manifestation of Tubercular infection in HIV/AIDS patient and its relationship with CD4 count i.e. level of immunosuppression and relationship with duration of disease.
Method: It was a prospective study done in Sarojini Naidu Medical College, Agra over a period of 18 months. All the patient who fulfilled the inclusion criteria and gave consent were included in the study
Result: We studied 106 HIV positive patients diagnosed with tuberculosis (pulmonary and extrapulmonary). It was observed that the prevalence of pulmonary tuberculosis was much higher than extrapulmonary tuberculosis (59.43% vs 40.57%) in HIV infected patients. The mean CD4count for pulmonary and extrapulmonary tuberculosis were 238/cumm and 117/cumm respectively. It was also observed that as the duration of illness increases the risk of getting extrapulmonary tuberculosis increases despite having same CD4 count. In pulmonary tuberculosis smear negative cases (55.56%) were more common than smear positive cases . Fever was the most consistent symptom and in chest x-ray upper lobe infiltration and non-cavitary lesion were more common.
Conclusion: Through this study we concluded that the incidence of tubercular infection increases with the decreasing level of immunosuppression and risk of extra pulmonary tuberculosis increases with increasing duration of illness.
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