Tuberculosis infection in HIV vs. non‐HIV patients

Abstract

Objectives Tuberculosis (TB) is the most common opportunistic infection and cause of mortality among people living with HIV, and it is possible that it may also influence the evolution of the HIV infection. We assessed the differences between HIV‐positive and ‐negative people infected with TB. Methods The present study is a cross‐sectional retrospective study by electronic record revision. We included patients admitted to a tertiary hospital with a diagnosis of TB between 2011 and 2016, comparing those with HIV coinfection with non‐HIV patients, according to demographic and clinical characteristics. Results This study included 591 patients, of whom 32% were HIV‐coinfected. HIV‐TB patients were younger, with a predominance of male gender. Considering TB risk factors, there was a higher prevalence of homelessness and intravenous drug use in the HIV group. In the non‐HIV group, direct contact with other patients with TB and immunosuppression were more prevalent. Relative to TB characteristics, the HIV‐coinfected group presents with a higher prevalence of disseminated disease and a higher occurrence of previous TB infection. Cancer was the most frequent cause of immunosuppression in the HIV group and the number testing positive for TB via microbiological culture was lower. Assessment of microbiological resistance and in‐hospital mortality showed similar numbers in both groups. Conclusions There are few papers comparing clinical course of TB between HIV‐infected and non‐infected patients. Our study differs from others in the literature as we focused on a country with middling incidence of TB and further characterized the differences between HIV‐infected and non‐infected patients which can contribute to the management of these patients.

Opportunistic Infections in the Immunocompromised: Hiv Vs Non-HIV Patients - A Narrative Review

“…tuberculosis is an airborne mycobacteria that causes tuberculosis (TB), one of the most common OI, besides a worldwide burden in immunocompetents 11 . Clinically it causes most frequently pulmonary infection but can affect any organ and cause disseminated infection, which depends on the degree of immunity 12 .…”

“…Primary infection can be followed by elimination from the body, or latent infection which can be later reactivated if immunocompromised. Immunosuppressed patients are also susceptible to reinfection 11,12 . TB presentation in HIV patients follows the degree of immunossupression 13,14 .…”

“…TB presentation in HIV patients follows the degree of immunossupression 13,14 . As the immune system function declines, pulmonary presentations are less frequent, with more frequent extra-pulmonary and disseminated presentations 11,13,14 . Imaging follows a similar evolution with the decline of the immune system and lower CD4 counts, from a non-HIV presentation like, into a more atypical one 11,[13][14][15] .…”

“…As the immune system function declines, pulmonary presentations are less frequent, with more frequent extra-pulmonary and disseminated presentations 11,13,14 . Imaging follows a similar evolution with the decline of the immune system and lower CD4 counts, from a non-HIV presentation like, into a more atypical one 11,[13][14][15] . Mortality is also higher in patients with HIV, when compared to immunocompetent patients 16,17 .…”

Utility of the lateral flow urine lipoarabinomannan tuberculosis assay in patients with advanced HIV disease at antiretroviral therapy centres in Mumbai, India

“…Globally tuberculosis (TB) remains the leading cause of death with 10 million incident cases and 1.5 million deaths in 2020 [ 1 , 2 ]. In people living with HIV (PLHIV), TB is the most common opportunistic infection (OI) responsible for hospitalization and deaths despite increased access to antiretroviral therapy (ART) [ 3 , 4 ]. The risk of developing TB is 18 (15–21) times higher among PLHIV [ 5 ].…”