To Study Clinical Profile of PLHA (People Living with HIV/AIDS) with Tubercular Co-infection: A Prospective Study at Tertiary Care Centre in North India

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Sanjay Fotedar1, Vikas Bhatti2, Vinay Rampal3, Zahid H. Gilani4, and Surinder Kumar5 (Department of Internal Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana1,2,5, Department of Internal Medicine, Govt. Medical College, Jammu, Jammu and Kashmir3, Department of Pharmacology, Govt. Medical College, Jammu, Jammu and Kashmir4)

People living with HIV/AIDS (PLHA) are at high risk of developing secondary infections, after seroconversion and with decreasing CD4 count the incidence of tuberculosis increases and adds to morbidity and mortality. Management includes concurrent treatment of HIV infection and specific management of tubercular infection. To study the clinical profile and disease outcome of tuberculosis in patients living with HIV/AIDS infection (PLHA). A prospective study from a tertiary care centre at Northern India. Patients with HIV/AIDS infection (PLHA) presenting with signs and symptoms of tuberculosis, diagnosed as cases of tuberculosis (pulmonary and extra pulmonary) were evaluated with respect to clinical profile, disease characteristics and socio demographic profile and respective data collected. 132 patients with HIV/AIDS infection diagnosed as cases of tuberculosis were included in study and data evaluated. Common clinical features included fever (84.4%), weight loss, (81.8%), cough with hemoptysis, followed by headache and altered sensorium. CD4 count <250 was significantly associated with tubercular infection with males effected more than females. Patients were diagnosed as having tubercular infection by AFB staining, Non-resolving pneumonitis on chest X-ray, HRTCT chest besides sputum culture, ESR, Monteux test, FNAC of lymph nodes and CSF study in extra pulmonary tubercular patients. The disease burden is more in developing and underdeveloped nations with high incidence of human immunodeficiency virus infection. Individuals infected with HIV infection may develop tubercular infection in course of HIV disease or may present with signs and symptoms of tubercular infection before being diagnosed as having HIV infection. The incidence of tubercular co-infection in PLHA is directly influenced by CD4 count and increases with fall in CD4 count. High degree of clinical suspicion with prompt evaluation for secondary infection including tuberculosis and timely management is associated with better outcomes.