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HIV-tuberculosis co-infection in an Indian scenario: the role of associated evidence of immunosuppression
Asian Pacific Journal of Tropical Medicine ; (12): 320-324, 2013.
Article in English | WPRIM | ID: wpr-820519
ABSTRACT
OBJECTIVE@#To determine the relationship between tuberculosis and the degree of immunosuppression as determined by CD4 count. The impact of immunosuppression on the severity of tuberculosis was also studied.@*METHODS@#A retrospective analysis was performed in patients newly diagnosed with HIV infection and antiretroviral therapy (ART)-naive patients with known HIV seropositivity. All patients were diagnosed with active tuberculosis between January 2008 and December 2010, based on review of their medical records. Patients on chemoprophylaxis for opportunistic infection were excluded. Pattern and severity of tuberculosis, associated stigmata of immunosuppression, and CD4 counts were noted.@*RESULTS@#Of 140 patients satisfying the inclusion criteria, 52 had mild tuberculosis with no other evidence of immunosuppression, 52 had tuberculosis of variable severity with associated evidence of immunosuppression, and 36 had severe tuberculosis with no other evidence of immunosuppression. The CD4 count was highest in the first group [(109.2±99.9) cells/μL] and least in the second group [(58.4±39.8) cells/μL], and the difference was statistically significant (P=0.004). No statistical difference was observed in the CD4 count between those with mild tuberculosis and those with severe tuberculosis.@*CONCLUSIONS@#In developing countries with a high prevalence of tuberculosis in the general population, the possibility of incidental tuberculosis in patients with HIV should always be considered. CD4 count does not appear to influence the severity of tuberculosis. The presence of concomitant evidence of immunosuppression in the form of category B and C conditions is indicative of underlying immunosuppression and associated with a significantly lower CD4 count.
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Tuberculosis / HIV Infections / Epidemiology / Retrospective Studies / Risk Factors / Analysis of Variance / CD4 Lymphocyte Count / Allergy and Immunology / Coinfection / Immune Tolerance Type of study: Etiology study / Observational study / Risk factors Limits: Adult / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: Asian Pacific Journal of Tropical Medicine Year: 2013 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Tuberculosis / HIV Infections / Epidemiology / Retrospective Studies / Risk Factors / Analysis of Variance / CD4 Lymphocyte Count / Allergy and Immunology / Coinfection / Immune Tolerance Type of study: Etiology study / Observational study / Risk factors Limits: Adult / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: Asian Pacific Journal of Tropical Medicine Year: 2013 Type: Article