Sugumar, M (2020) Study of Presentations and Treatment Outcome of Tuberculosis in HIV / AIDS Patients and Its correlation with CD4 Count. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
BACKGROUND: The risk of development of active TB from latent infection is 5-10% for lifetime in non-HIV patients and 10% per year or 30% over lifetime in HIV patients. Extrapulmonary TB accounts for 15-20% in non-HIV individuals but up to 50% in patients with advanced HIV infection. The radiological findings may vary widely depending on the degree of immunosuppression. OBJECTIVE: To study about the presentations and treatment outcomes of HIV-TB co-infection and its correlation with the CD4 count. MATERIALS AND METHODS: A prospective study of 100 HIV patients with any form of TB which was newly diagnosed in the period of January 2018 to June 2019 were selected. Clinical symptoms, radiological features, sputum examination, biological fluid analysis reports, CD4 count and events during treatment initiation and follow up were noted. RESULTS: Atypical presentations like miliary pattern, adenopathy, effusion more commonly seen with lower CD4 count (< 200/cumm) (p < 0.013) and middle and lower zone involvement also seen mostly lower CD4 count (p < 0.0002). CXR was normal in 17.5%.Occurrence of EPTB with or without PTB also seen mostly with lower CD4 group (p < 0.029). Only 6.8% of EPTB were microbiologically confirmed and the remaining was clinically diagnosed. 4.4% of primary Rifampicin resistance seen. Mortality was mostly seen in patients with lower CD4 count (p < 0.033). CONCLUSION: There are difficulties in confirming the diagnosis of EPTB. CD4 count correlates well with most of the clinical, radiological presentations and mortality. Effective implementation of treatment for both the diseases will lead to better outcomes.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201727203 |
| Uncontrolled Keywords: | HIV-TB co-infection, CD4 count, radiological findings, opportunistic infections. |
| Subjects: | MEDICAL > Tuberculosis and Respiratory Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 04 Feb 2021 16:31 |
| Last Modified: | 04 Feb 2021 16:31 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13814 |
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