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Abstract
Sputum smear examination for AFB-Not an exhaustive tool to diagnose TB and HIV co-infection
Rajkumar K.1, Dorairaj V.S.1, Kalaivani D.1, Cynthia D.1
Objectives: Mycobacterium tuberculosis is a frequent co-pathogen in patients with HIV.It is the single most commonly seen co-infection among the HIV infected persons in developing countries.The HIV pandemic has increased the burden of TB among young adults especially in populations where the prevalence of TB infection is high.This study focuses on the merits and demerits of sputum smear examination in identifying co-infected victims of TB and HIV, in resource limited settings of developing countries,which are highly endemic for HIV.
Methods: Study was conducted between JAN 2005 and DEC2006 at HIV clinic,General Hospital chennai. 263 adult patients,of both sexes who were confirmed cases of HIV infection , with chest symptoms of cough more than 2 weeks,unexplained dyspnea, haemoptysis and other symptoms like fever more than 3 weeks, lymphadenopathy were included in the study. All the patients were subjected to the following investigations namely,3 specimens of sputum examination,X-ray chest,mantoux test,sputum culture and CT scan chest.
Results: Out of 263 HIV positive chest symptomatics screened following results were got VIZ., 21 patients of both sexes were sputum positive,(8%) Of the remaining 242 patients who were sputum negative, 10 patients were culture positive for TB bacilli,(4%), 25 patients had X-ray findings compatible with TB(10%)
Conclusions: Percentage of sputum smear positivity among HIV positive patients is less than in HIV negative TB patients.Severe immunosuppression among HIV patients with pulmonary TB,leads on to very high bacterial load.Such patients are unable to combat with a granulomatous response in the lung tissues against Mycobacterium tuberculosis and hence less cavitation and excretion of fewer bacilli from the lungs.Hence by relying on sputum smear results alone for diagnosing TB infection in HIV patients,we are prone to miss many cases.If we include other modalities like X-ray chest, culture, and CT scan chest the scope of pin-pointing co-infected patients greatly increases.
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention
Abstract no.
CDB163
Suggested Citation
"RajkumarK., et al.
Sputum smear examination for AFB-Not an exhaustive tool to diagnose TB and HIV co-infection.
:
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention:
Abstract no.
CDB163"
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