Impact of HIV infection on tuberculosis

Zumla, Alimuddin; Maloň, Petr; Henderson, Jane; Grange, John M.

doi:10.1136/pmj.76.895.259

Cited by 122 publications

(99 citation statements)

References 57 publications

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“…In the event of HIV, it is now re-emerging [2,11]. The spine is the site most commonly affected with tuberculosis, followed by the hip and the knee [23,25].…”

Section: Discussionmentioning

confidence: 99%

The role of polymerase chain reaction in the management of osteoarticular tuberculosis

Pandey

Chawla

Acharya

et al. 2007

International Orthopaedics (SICOT)

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A dependable method for the rapid diagnosis of osteoarticular tuberculosis has become increasingly important, as routine methods are neither very sensitive nor very specific. The objective of this study is to verify the reliability of polymerase chain reaction (PCR) in the diagnosis and management of osteoarticular tuberculosis. This investigation was a prospective study conducted at the Kasturba Medical College, Manipal, India. Tissue samples of 74 patients suspected of osteoarticular tuberculosis were sent for PCR and histopathologic examination. Taking histopathology as the gold standard, PCR has a sensitivity of 73.07% and a specificity of 93.75% (with 95% confidence interval [CI] 62.97; 83.17).The positive agreement between histology and PCR was 0.693, indicating good agreement. PCR showed a sensitivity of 90% with spinal samples. It has a low false positivity of 13.63%. We conclude that conventional methods are neither sensitive nor specific enough and are also time consuming. PCR is an effective method for diagnosing tuberculosis and antitubercular treatment can be started if PCR is positive, since false-positive rates are very low.Résumé Une méthode pour le diagnostic rapide des tuberculoses osseuses articulaires voit sont importance augmenter par rapport aux méthodes de routine cependant très sensitives mais peu spécifiques. L'objectif de cette étude est de vérifier la fiabilité de la PCR (polymérase réaction en chaêne) diagnostic dans la conduite et le traitement des tuberculoses ostéo articulaires. Matériel et méthode: au cours d'une étude prospective conduite au Collège Médical Kasturba de Manipal Indes, les fragments tissulaires de 74 patients suspects de tuberculose ostéo articulaire ont été adressés, pour examen histopathologique et dosage PCR. Résultats: l'histopathologie reste le « gold standard », la PCR a une sensitivité de 73.07% et une spécificité de 93.75% (avec 95% d'intervalle de confiance CI 62.97; 83.17). La compatibilité entre histologie et la PCR est de 0.693, la PCR montre une sensitivité de 90% avec du tissu rachidien. Il existe des faux positifs (13.63%). Conclusion: les méthodes conventionnelles ne semblent ni sensitives ni spécifiques et demandent beaucoup de temps. La PCR est une méthode diagnostique de la tuberculose fiable et permet de suivre et de démarrer le traitement anti tuberculeux si la PCR est positive, les taux de faux positifs étant très bas.

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“…In the event of HIV, it is now re-emerging [2,11]. The spine is the site most commonly affected with tuberculosis, followed by the hip and the knee [23,25].…”

Section: Discussionmentioning

confidence: 99%

The role of polymerase chain reaction in the management of osteoarticular tuberculosis

Pandey

Chawla

Acharya

et al. 2007

International Orthopaedics (SICOT)

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“…1 The pandemic of HIV causing AIDS is the major contributor in increasing the incidence and mortality of TB. 2 Approximately one third of people living with HIV are co-infected with TB.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, Characteristics, Management, and Outcome of Pulmonary Tuberculosis in HIV-Infected Children in the TREAT Asia Pediatric HIV Observational Database (TApHOD)

Sudjaritruk

Maleesatharn

Prasitsuebsai

et al. 2013

AIDS Patient Care and STDs

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A multicenter, retrospective, observational study was conducted to determine prevalence, characteristics, management, and outcome of pulmonary tuberculosis (PTB) in Asian HIV-infected children in the TREAT Asia Pediatric HIV Observational Database (TApHOD). Data on PTB episodes diagnosed during the period between 12 months before antiretroviral therapy (ART) initiation and December 31, 2009 were extracted. A total of 2678 HIV-infected children were included in TApHOD over a 13-year period; 457 developed PTB, giving a period prevalence of 17.1% (range 5.7-33.0% per country). There were a total of 484 PTB episodes; 27 children had 2 episodes each. There were 21 deaths (4.3%). One third of episodes (n = 175/484) occurred after ART initiation at a median of 14.1 months (interquartile range [IQR] 2.5-28.8 months). The median (IQR) CD4 + values were 9.0% (3.0-16.0%) and 183.5 (37.8-525.0) cells/mm 3 when PTB was diagnosed. Most episodes (n = 424/436, 97.3%) had abnormal radiographic findings compatible with PTB, whereas half (n = 267/484, 55.2%) presented with clinical characteristics of PTB. One third of those tested (n = 42/122, 34.4%) had bacteriological evidence of PTB. Of the 156 episodes (32.2%) that were accompanied with extrapulmonary TB, pleuritis was the most common manifestation (81.4%). After treatment completion, most episodes (n = 396/484, 81.9%) were recorded as having positive outcomes (cured, treatment completed and child well, and improvement). The prevalence of PTB among Asian HIV-infected children in our cohort was high. Children with persistent immunosuppression remain vulnerable to PTB even after ART initiation.

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“…In patients with relatively intact immune function (CD4+ count >200/mm3), pulmonary TB (PTB) is more frequently seen than extra pulmonary TB (EPTB). 23,24 In these patients, chest radiographic findings include upper lobe infiltrates and cavitation, similar to those in HIV-negative individuals with PTB. 25 Sputum smears are often positive for acid-fast bacilli (AFB) in these patients.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of pulmonary tuberculosis in retroviral positive chest symptomatics in a tertiary care hospital, South India

Sankari¹,

Ramaswamy²

2016

Int J Res Med Sci

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Impact of HIV infection on tuberculosis

Cited by 122 publications

References 57 publications

The role of polymerase chain reaction in the management of osteoarticular tuberculosis

The role of polymerase chain reaction in the management of osteoarticular tuberculosis

Prevalence, Characteristics, Management, and Outcome of Pulmonary Tuberculosis in HIV-Infected Children in the TREAT Asia Pediatric HIV Observational Database (TApHOD)

Prevalence of pulmonary tuberculosis in retroviral positive chest symptomatics in a tertiary care hospital, South India

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