Clinical profile of 128 HIV positive cases with abdominal tuberculosis
Keywords:AKT, Splenic abscesses, Lymphadenopathy
Background: Tuberculosis and HIV co-infection remains a major public health challenge throughout the world. An extra 25% of deaths among TB patients are attributable to co-infection with HIV according to the WHO 2009 TB report. TB is often the first opportunistic infection and a leading cause of death in HIV infected persons. The main objective was to study the clinical profile of the patients co-infected with HIV and abdominal tuberculosis in Government Medical College, Aurangabad.
Methods: Patients co-infected with HIV and abdominal tuberculosis were included in this observational study. Patients were either HIV positive and later diagnosed to have abdominal tuberculosis or diagnosed to be HIV positive when investigations were done after the diagnosis of abdominal TB. The common presenting symptoms were weight loss, fever, loss of appetite, pain in the abdomen and chronic diarrhoea. Ultrasound and routine chest X-ray were done along with other routine blood investigations including CD4 count.
Results: We studied 407 cases of HIV-TB co-infected patients out of whom 248 (61%) were of extra-pulmonary tuberculosis. Out of 248, 128 cases (51.6%) were diagnosed to have abdominal tuberculosis which was the commonest type of extra pulmonary tuberculosis in HIV –TB co- infected patients. They had higher morbidity, but we found that 96.06% patients completed anti-tubercular treatment and responded. Mortality rate of abdominal TB was lowest (3.94%) among all types of extra-pulmonary and also pulmonary TB in HIV co -infected patients. So we can conclude that HIV TB co infected patients show good response to anti- tubercular treatment if we diagnose this condition early.
Conclusions: Abdominal tuberculosis is the commonest type of extra pulmonary tuberculosis in HIV patients. On ultrasonography, the common abnormalities seen were intra-abdominal lymphadenopathy, splenic abscesses, ascites etc. All the patients who were diagnosed within few weeks of symptoms recovered with anti tubercular therapy, similar to HIV negative patients.
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