ABSTRACT
Background:Diagnostic of Pulmonary tuberculosis (PTB) in patients with Human immunodeficiency virus (HIV) infection remain challenging. Evaluation based on clinical symptoms, inflammation biomarkers, and immunodeficiency status, can provide a feature of PTB disease in HIV patient. The aim of thestudy was to analyze the relationship between acute phase reactant and immunodeficiency status with PTB in patients with na飗e HIV infection.Methods:A cross sectional study was conducted in Sanglah General Hospital and Kuta Selatan Public Health Service on February-June 2021. C-reactive protein (CRP), Ferritin serum levels, and CD-4 cell count were obtained from patient's serum. Data were collected by questionnaire. Bivariate analysis using Chi square test or Kolmogorov Smirnovtest, and multivariate analysis using logistic regression.Results:A total of 60 participants were included in this study, and 58.3% had pulmonary tuberculosis (38.3% bacteriologically confirmed, 20% clinically confirmed). Fifty five percent participants had CRP level ?10 mg/l, 83% had ferritin serum level ?260ng/ml, and 83% had CD4 cell count<200 cell/ml. Multivariate analysis showed that the most influential factor for PTB in HIV patients was CRP level?10 mg/l (adjusted prevalence ratio/APR=4.9; 95%CI=7.81-2327,04,p=0.001) and ferritin serum level ?260 ng/ml(APR=3.32,95%CI=1.752-433.65,p=0.018).Conclusions:High CRP and ferritin serum levels were significantly related with PTB in naive HIV patients. No relationship was found between low CD4 cell count and PTB in naive HIV patients
ABSTRACT
Background: Drug-induced hepatitis (DIH) is a side effect of the usage of anti-tuberculosis (TB) drugs, which can cause alteration in treatment regiments and prolonged treatment. This study aim is to identify the risk factors that can be used to predict the occurrenceof DIH on tuberculosis (TB) patients.Methods: This was a case-control study, conducted at Sanglah central general hospital in Denpasar from January to June 2021. Data collection was carried out through the medical records of inpatients and outpatients who received fixed-dose combination anti-TB drug.Results: There were 62 research samples which were divided into 31 samples in the case group and 31 samples in the control group. The clinical manifestations of DIH were vomiting (32.8%), nausea (15.7%), abdominal pain (13.1%), and hepatic encephalopathy (1.3%). Median time to onset of DIH was 18 (Interquartile range: 19) days. Low BMI was a significant risk factor for DIH (AOR=22.4; 95%CI 4.147-121.575; p<0.001). Other clinical characteristic variables such as age, female, extrapulmonary TB, positive HIV status, diabetes mellitus, hypoalbuminemia, and eosinophilia were not proven risk factors for DIH-TB.Conclusions: Low BMI was a significant risk factor for DIH. Other variables such as age, female, extrapulmonary TB, positive HIV status, diabetes mellitus, hypoalbuminemia, and eosinophilia were not risk factors for DIH in TBpatients