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Abstract
PARADOXICAL REACTION IN PATIENTS CO-INFECTED WITH HIV AND TUBERCULOSIS
F. Serra, S.S. Carvalho, M.A. Vieira, V. Rolla
Instituto de Pesquisa Clinica Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil
Introduction: Paradoxical reaction (PR) to tuberculosis (TB) in patients with HIV/AIDS has been poorly studied although its importance and frequency.
Objective: To describe cases of PR in patients with TB.
Methods: Prospective longitudinal descriptive study. All patients with TB diagnosis followed from January de 2000 to January 2003 in our center who presented PR were included.
Results: We followed 147 individuals from whom 63 (43%) were HIV- and 84 (57%) were HIV+, 42 (50%) treated with HAART. From the HIV+, 10 (12%) presented PR (7 males e 3 females). PR occurred in 9/42 patients treated with HAART (21%). The most frequent TB form was lymph node (40%), followed by pulmonary (30%), pulmonary and lymph nodes (20%), and disseminated (10%). All but one patient presented cervical lymph node enlargement during TB diagnosis. During PR, cervical lymph node enlargement varied from 3 to 9cm diameter. From those 10 patients, 40% presented CD4 counts below 100 cells/mm3 close to TB diagnosis and 50% 100-200 cells/mm¦.
In patients treated with HAART, PR occurred in a mean time of 58 days (( 64 days) after HAART introduction. PPD reaction was absent in all but two naive patients who were treated with HAART before TB diagnosis. PR was treated with prednisone and recovery was observed in a mean of 91 days ((30 days). No deaths were observed among those patients related with PR.
Conclusion: PR in our study was very frequent and occurred mainly in patients presenting lymph node enlargement during TB diagnosis.
The 2nd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
881
Suggested Citation
" F. Serra, et al.
PARADOXICAL REACTION IN PATIENTS CO-INFECTED WITH HIV AND TUBERCULOSIS.
Poster:
The 2nd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
881"
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