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 ORIGINAL ARTICLE
Year : 2006  |  Volume : 72  |  Issue : 4  |  Page : 276--282

HIV and tuberculosis: Partners in crime


1 Department of Infectious Diseases, Jaslok Hospital and Research Centre, Mumbai, India
2 Foundation for Medical Research, Mumbai, India
3 Department of Medicine, Imperial College London, Chelsea and Westminster Hospital London, United Kingdom
4 Department of HIV Medicine, Apollo Hospital, Ahmedabad, India
5 Dr. Maniar's ID clinic, Mumbai, India

Correspondence Address:
Janak K Maniar
69/2, Walkeshwar Road, Mumbai - 400 006
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0378-6323.26723

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Background: Tuberculosis is the commonest infection detected in HIV-infected individuals worldwide. Aim: The aim of this study is to describe the clinical, bacteriologic and radiological spectrum of tuberculosis (TB) in the setting of human immunodeficiency virus (HIV) infection in a tertiary care centre in Mumbai. Methods: A total of 8640 HIV-infected individuals were screened for tuberculosis routinely from January 1998 to December 2003, using clinical examination, chest X-ray and abdominal ultrasonography, sputum smears for acid-fast bacilli (AFB) and culture on Lowenstein-Jensen medium. Results: TB was detected in 8078 (93.5%) patients of whom 3393 (42%) had pulmonary, 3514 (43.5%) had extrapulmonary TB and 1171 (14.5%) had disseminated disease. One thousand two hundred thirty eight patients (36.5%) showed AFB in sputum, while 1154 (34%) showed growth on culture medium and 4174 had radiographic involvement. In 781 (67%) individuals disseminated disease coexisted with pulmonary involvement. All 8078 coinfected patients were treated with anti-TB therapy (ATT), of whom 6422 patients (79.5%) showed one or more adverse events. Gastritis was the commonest complaint followed by hepatitis and skin rashes. ATT resistance was detected in 482 individuals. Conclusion: Tuberculosis is the commonest opportunistic infection (OI) in HIV positive patients in India, showing a higher prevalence of extrapulmonary and disseminated TB and adverse events due to ATT. Early recognition of concurrent OIs and their adequate treatment and prophylaxis is essential.






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