A study of the prevalence of HIV-1 infection in cases of pulmonary tuberculosis

Abstract

Background: H.I.V. infection usually requires several years to progress to A.I.D.S., which is the final stage of disease characterized by severe immuno-suppression. Clinically significant problems occur earlier in the natural history of H.I.V. infection, however, pulmonary disorders are found in all stages. Aim: Present study is mainly based to observe the prevalence of H.I.V.-1 infection and A.I.D.S. in pulmonary tuberculosis . Materials and
methods: The present study of the prevalence of H.I.V-I infection in pulmonary tuberculosis was conducted on 52 bacillary cases of pulmonary tuberculosis. 25 healthy, age, and sex matched control cases were taken. H.I.V-1 infection was determined by testing the serum of the cases with Retro-Tek H.I.V.-1 E.L.I.S.A. method. Results: The majority of pulmonary tuberculosis cases were found in the age group 30-49. The disease was more common in males than in the females with M:F::2.5:1 ratio. At the time of admission into the study all the patients had complains of cough with sputum production. Majority had fever, loss of appetite, loss of weight, breathlessness. Other symptoms like haemoptysis, chest pain were also found in varying proportion. On clinical examination most of the patients had signs of infiltration, fibrocavity, fibrosis. About 2/3rd of the patients were radiologically far
advanced. Moderately advanced lesions were found in rest of the cases. Where as only 6% had minimal lesions. The mode of transmission of HIV infection was probably heterosexual as none of the patients had previous history of homosexuality, blood transfusion, surgery. More number of HIV-1 seropositive TB cases (25%) had serum for VDRL. significantly reactive than HIV-1 seronegative TB cases (17.5). Majority of HIV-1 seropositive TB cases gave history of promiscuity (75%) than the HIV-1 seronegative TB cases(47.5%). In the 52 cases of pulmonary tuberculosis selected for the study, 37 cases were non-reactive . The remaining 15 cases were found to be reactive and , of these initial reactive cases when test was repeated 14 cases were found to be reactive again and were referred to as "repeatably reactive". When test was repeated in 12 of these 14 repeatably reactive cases 10 were found to be reactive again. Thus over all 10 cases were reactive for H.I.V-1 infection three times and 2 cases were reactive for two times. Conclusion: Anti-tuberculosis treatment was found to be equally efficacious in both HIV-1 seropositive and seronegative pulmonary tuberculosis patients. Sputum smear conversion for A.F.B. bacilli was not influenced by HIV-1 infection.