Cuesta F; International Conference on AIDS.
Int Conf AIDS. 1996 Jul 7-12; 11: 119 (abstract no. We.B.3358).
Internal Medicine Department, Juan Ramon Jimenez Hospital, Huelva, Spain.
Methods: Retrospective study of 101 patients with coinfection VIH-TB diagnosed and followed from January 1st 1993, to December 31 1995. Patient medical records were reviewed. TB was diagnosed by identification of M. tuberculosis in Lowenstein media or the association of response to specific treatment with AARB in any specimen and/or clinical, radiological and histological criteria. Results: Lung TB was present in 37 patients (pts) (36,63%), five with pleural involvement. Disseminated TB was diagnosed in 64 patients (63,37%). The mean age was 30 years. Ninty one patients were men. 92,63% were IDUs. Previous TB was present in 36,63%, localizated lung TB in 17 and 20 with extrapulmonary site involvement. 24% was at prison before admission, and 20% were living in open communities. 64,58% of pts were in C3 stage, 17 with lung TB and 45 with disseminated TB; 28,12% in C2 and 7.30% in C1 (CDC classification). The mean CD4 cell count was 201 in pts wih lung TB (CI 121,87-279,78), and 119 in disseminated TB group (CI 86,58-151,49). The involved sites in the TB disseminated group were: 39 lymph nodes (LN), 34 lung, 12 liver, 8 meningeal, 3 encephalitis, 6 bone marrow, 2 testis, 1 kidney and 1 ileus. The Rx lung film was normal in 25% of the disseminated group and none of the lung TB group (p is less than 0,001). The radiological patterns associated with the more productive forms were interstitial pattern with more than one lobe involvement. Only in the lung TB group cavitation (11 pts) and pneumothorax (2 pts) were seen. Splenomegaly was present in 33% of pts with disseminated TB and only 11% in the lung TB group (p is less than 0,05). 72% of pts were treated with INH+RIF+PZA, 21% with INH+RIF+PZA+ETB and 7% with INH+RIF+ETB and a good clinic and microbiological response was obtained. Hepatotoxicity by INH was observed in five pts, 4 in the disseminated group, but only in one patient definitive suspension was necessary, there was no relationship with previous liver disease, other treatments, nor antituberculous regimen. Empiric treatment was used in 20 pts, eleven of them had FUO. The treatment was withdrawn by 30,69% of pts (CI 22,1052-40,772) no relationship with IVDUs, prison nor gender was observed. No drug resistance was suspected. Conclusions: The disseminated form with LN and lung involvement is the most frequent presentation of TB in our series. The normal Rx thorax film and splenomegalie is frequent in these patients. More than one third of pts had previous TB, and a similar rate withdrew from the treatment. Some fourth part was at prison. Toxicity was present in only 5% pts.
Publication Types:
Keywords:
- AIDS Vaccines
- Acquired Immunodeficiency Syndrome
- CD4 Lymphocyte Count
- Communicable Diseases
- HIV Infections
- HIV Seropositivity
- Humans
- Isoniazid
- Male
- Prisons
- Retrospective Studies
- Tuberculosis
- Tuberculosis, Pulmonary
Other ID:
UI: 102219606
From Meeting Abstracts