|
|
Abstract
The coughing patient: TB or not TB, that is the question
Laufer N.1, Cabrini M.1, Abusamra L.2, Figueroa M.I.1, Sued O.2, Hansen R.1, Sisto A.1, Pérez H.1, Salomón H.3, Cahn P.1
Objective: To define clinical and epidemiological characteristics that could clinically identify pulmonary TB in HIV patients.
Methods: All patients coughing patients attending to a single HIV clinic, between 10/2004 and 04/2006, were asked to participate. Patients who signed consent filled a questionnaire and their clinical records were evaluated prospectively. Chest X-Rays were classified according to the classification described by P Tattevin (Chest 1999; 115; 1248-1253). Epidemiological and clinical data were compared between patients with diagnosis of HIV/TB and those with HIV and other diagnosis. X2 and t-test were used to compare data.
Results: Out of 9245 unscheduled visits, 286 patients presented with cough. Consent was signed by 246 patients: 35/246 (14%) had confirmed diagnosis of TB; 211 had other diagnosis, mainly PCP (24%) and community acquired pneumonia (33%). Patients with TB/HIV presented more frequently liver enlargement (17%/4%, p=0.005), enlarged spleen (13%/0.5%, p=0.003), night-sweats (74%/38%, p=0.001), weight-loss > 5kg (69%/43%, p=0.003), duration of symptoms between 15-30 days (21%/9%, p=0.03), increased levels of alkaline phosphatase (21%/2%, p=0.03), chest X-Ray typical (30%/4%, p=0.0003) or compatible (39%/16%, p=0.013) with TB; and contact with TB-patient (21%/7%, p=0.02). No difference was found (p >0.05) regarding hemoptysis, pulmonary physical examination, previous TB or incarceration, lower educational level, LT-CD4 count, HIV-1 viral load, number or previous opportunistic infections, white blood cell count.
Conclusions: TB diagnosis was found in 14% of patients with cough. In countries with high incidence of TB such as Argentina, the diagnosis of TB in HIV patients with pulmonary symptoms must be always considered but particullarly in those patients with weight-loss > 5 kg, night-sweats, and duration of symptoms between 15-30 days. Also liver and spleen enlargement and chest X-ray should increase physicians’ suspicion of TB in HIV co-infected patients.
Funded by: Fogarty International Center/NIH (Grant # 5D43 TW0010137).
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention
Abstract no.
MOPEB026
Suggested Citation
"LauferN., et al.
The coughing patient: TB or not TB, that is the question.
Poster exhibition:
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention:
Abstract no.
MOPEB026"
|
|
|