Meta-Analysis: The Association Between HIV Infection and Extrapulmonary Tuberculosis

Naing, Cho; Jw, Mak; Maung, Mala; Wong, Shew Fung; Kassim, Ani Izzuani Binti Mohd

doi:10.1007/s00408-012-9440-6

Cited by 104 publications

(85 citation statements)

References 38 publications

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“…In a study conducted in Turkey, tuberculosis was found to be the most common cause of infectious reasons for fever of unknown origin (19). Tuberculosis has even been considered in the differential diagnosis of arthritis and of malignancies due to M. tuberculosis complex, which causes granulomatous lesions (15,(20)(21)(22). In light of these data, pulmonary tuberculosis patients, who are the main source of new pulmonary or extrapulmonary tuberculosis cases, should be diagnosed immediately.…”

Section: Discussionmentioning

confidence: 99%

Applicability of Xpert MTB/RIF assay for routine diagnosis of tuberculosis: a four-year single-center experience

Çelik¹,

Gözel²,

Bakıcı³

et al. 2015

Turk J Med Sci

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The aim of this study is to assess the Xpert MTB/RIF assay for diagnosis of the Mycobacterium tuberculosis complex in clinical samples and to compare the results by reference to the diagnostic method, Bactec MGIT 960. Materials and methods:A total of 7407 samples were included from patients not primarily suggesting pulmonary or extrapulmonary tuberculosis (TB), collected from patients required to be screened for TB and excluding TB diagnoses since it was a differential diagnosis. Also included were a total of 411 samples from patients primarily suggesting pulmonary or extrapulmonary TB.Results: In the first group, 152 of 7407 samples yielded positive results with the Bactec MGIT 960, 131 (1.77%) were found positive with Löwenstein-Jensen medium, and 295 (3.99%) were found positive with Ziehl-Neelsen staining. In the second group, 24 (5.8%), 17 (4.1%), and 28 (6.8%) of 411 samples were found positive. Xpert MTB/RIF [27 (6.6%) of 411 samples] detected 3 additional samples as positive, and these 3 cases were clinically compatible with TB. Conclusion:The Xpert MTB/RIF assay shows superior performance for the diagnosis of TB. Its usefulness in culture-negative patients and the best method for integrating this diagnostic method into current tuberculosis diagnostic algorithms both need further study.

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Section: Discussionmentioning

confidence: 99%

Applicability of Xpert MTB/RIF assay for routine diagnosis of tuberculosis: a four-year single-center experience

Çelik¹,

Gözel²,

Bakıcı³

et al. 2015

Turk J Med Sci

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“…10,17 In fact, EPTB is considered an AIDS defining disease. 18 HIV co-infection is associated with more severe forms of EPTB, such as disseminated and meningeal TB, and a higher risk of death. 19 Studies have shown that patients with EPTB tend to deteriorate more rapidly and have higher mortality rates as compared to patients with pulmonary TB.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with mortality in extrapulmonary tuberculosis patients at a teaching hospital in Ghana

Nassikas¹,

Yang²,

Forson³

et al. 2016

Ghana Medical Journal

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SUMMARYObjectives: To investigate the clinical manifestations and factors associated with mortality in patients with extrapulmonary tuberculosis (EPTB) at the Korle-Bu Teaching Hospital Chest Clinic in Accra, Ghana. Design: We conducted a retrospective chart review of patients treated for EPTB at the Chest Clinic between January 1, 2009 and December 31, 2011. Patients with a new diagnosis of EPTB without concomitant pulmonary disease, aged 18 years or older, and who were treated at the Chest Clinic were eligible for participation in the study. Relevant data were abstracted from medical records and entered into a database. The factors associated with mortality were examined using bivariate and multivariate analysis. Results: Of the 157 patients in the study, the most affected age group was 25-34 years old (33.1%), 57.3% were male, and 71 (55.5%) of the 128 patients tested for HIV were sero-positive. Overall, 62 (39.5%) died during EPTB treatment. Mortality was associated with disseminated TB (AOR 149.85; P < 0.001), TB meningitis (AOR 79.14; P < 0.001), abdominal TB (AOR 23.59; P = 0.011), pleural effusion (AOR 12.6; P = 0.021) and age (AOR 1.05; P = 0.021). Among HIV co-infected patients, early initiation of ART reduced mortality rate. Conclusions: The site of EPTB was a key determinant of mortality. Given that death occurs soon after diagnosis, patients with suspected TB meningitis, disseminated, abdominal and pleural TB should be targeted for early diagnosis and treatment to reduce the high EPTB mortality in our setting.

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“…Pneumocystis jiroveci was the most common respiratory disease, especially among females, while cerebral toxoplasmosis was the most commonly identified intracranial mass lesion. Extrapulmonary TB was more common than pulmonary TB, as previously reported in patients with very low CD4 counts (25). However, findings of such a low prevalence should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 48%

Clinical profile and factors associated with mortality in hospitalized patients with HIV/AIDS: a retrospective analysis from Tripoli Medical Centre, Libya, 2013

Shalaka

Garred

Zeglam

et al. 2015

Easter Mediterr Health J

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In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older (40.0 versus 36.5 years), reported injection drug use (58.3% versus 0%) and were hepatitis C virus co-infected (65.8% versus 0%) compared with females. Severe immunosuppression was prevalent (median CD4 count = 42 cell/µL). Candidiasis was the most common diagnosis (26.0%); Pneumocystis pneumonia was the most common respiratory disease (8.8%), while cerebral toxoplasmosis was diagnosed in 8.4% of patients. Current HAART use was independently associated with low risk of in-hospital mortality (OR 0.33), while central nervous system symptoms (OR 4.12), sepsis (OR 6.98) and low total lymphocyte counts (OR 3.60) were associated with increased risk. In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality. . Le diagnostic le plus fréquent était la candidose (26,0 %) ; la pneumonie à Pneumocystis était la maladie respiratoire la plus fréquente (8,8 %), tandis que la toxoplasmose cérébrale était diagnostiquée chez 8,4 % des patients). Un traitement antirétroviral hautement actif en cours était indépendamment associé à un faible risque de mortalité en milieu hospitalier (OR 0,33), tandis que les symptômes du système nerveux central (OR 4,12), la septicémie (OR 6,98) et les faibles numérations lymphocytaires totales (OR 3,60) étaient associés à un risque accru. Dans cette étude, une présentation tardive accompagnée d'une immunosuppression sévère était fréquente, et était associée à une mortalité élevée en milieu hospitalier.

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Meta-Analysis: The Association Between HIV Infection and Extrapulmonary Tuberculosis

Abstract: Findings show evidence on the association between extrapulmonary tuberculosis and HIV, based on case control studies. Further studies to understand the mechanisms of interaction of the two pathogens are recommended.

Cited by 104 publications

References 38 publications

Applicability of Xpert MTB/RIF assay for routine diagnosis of tuberculosis: a four-year single-center experience

Applicability of Xpert MTB/RIF assay for routine diagnosis of tuberculosis: a four-year single-center experience

Factors associated with mortality in extrapulmonary tuberculosis patients at a teaching hospital in Ghana

Clinical profile and factors associated with mortality in hospitalized patients with HIV/AIDS: a retrospective analysis from Tripoli Medical Centre, Libya, 2013

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