Characteristics of pulmonary tuberculosis in HIV seropositive and seronegative patients in a Northeastern region of Brazil

Abstract

The aim of this study was to analyse the clinical, epidemiological and bacteriological features present in 60 pulmonary tuberculosis patients who were also infected with human immunodeficiency virus (HIV) and to compare these with 120 TB patients who were not infected with HIV. The patients with pulmonary tuberculosis and HIV coinfection were mostly male (p = 0.001), showed a higher frequency of weight loss >10 kilos (p <0.001), had a higher rate of non-reaction result to the tuberculin skin test (p <0.001), a higher frequency of negative sputum smear examination for acid-fast bacilli (p = 0.001) and negative sputum culture for Mycobacterium tuberculosis (p = 0.001). Treatment failure was more common in those who were HIV positive (p <0.000). No higher frequency of resistance to antituberculosis drugs was found to be associated with TB/HIV coinfection (p = 0.407). Association between extrapulmonary and pulmonary tuberculosis was more frequent in those seropositive to HIV than those without HIV virus, 30% and 1.6% respectively. These findings showed a predominance of atypical clinical laboratory features in co-infected patients, and suggest that health care personnel should consider the possibility this diagnosis.

Aspectos epidemiológicos da co-infecção tuberculose e vírus da imunodeficiência humana em Ribeirão Preto (SP), de 1998 a 2003

“…The extrapulmonary clinical form of TB was more common in HIVpositive patients than in HIV-negative patients (25.5% vs. 14%). (11)(12)(13) In terms of treatment outcome, we used only the following outcome measures: cure, abandonment, death or relocation. Of the TB/HIV co-infected patients, 52.5% were cured, 11% abandoned treatment, 33% died, and 3.5% were relocated.…”

“…Some authors (11) have reported that TB/HIV coinfection is more common in males, a condition not observed among individuals infected with TB alone. In the present study, a similar situation was observed: males were more often affected by such co-infection than were females.…”

High prevalence of drug-resistant tuberculosis and other mycobacteria among HIV-infected patients in Brazil: a systematic review

“…Five studies were laboratory-based. Data were collected retrospectively in all the studies but two (Liberato et al 2004, Brito et al 2010. Seven studies were designed to enrol both HIV-positive and HIVnegative patients.…”

“…Data concerning resistance to specific anti-TB drugs among HIV-infected patients were discernible in seven of the selected studies (Santi et al 2001, Lemos et al 2004, Liberato et al 2004, Rozman et al 2007, Wolfart et al 2008, Zamarioli et al 2009, Nunes et al 2010. The global resistance rate (both primary and acquired) to isoniazid alone ranged from 3.6-18.7%, while resistance to rifampicin alone ranged from 0.2-9.1%.…”

Identificação laboratorial de micobactérias em amostras respiratórias de pacientes HIV-positivos com suspeita de tuberculose

“…Froes e cols 14 em Minas Gerais obtiveram um acréscimo de 19,4% no diagnóstico da TB com a realização da cultura; Boffo e cols 6 alcançaram um rendimento maior da cultura em 10,2% no diagnóstico de sintomáticos respiratórios; e Liberato e cols 23 , no nordeste brasileiro, verificaram acréscimo de 10,6% na positividade da cultura em relação à baciloscopia do escarro de pacientes HIV-positivos.…”