Abstract:

Background: Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) constitute the main burden of infectious disease in resource-limited countries. In the individual host, the two pathogens, Mycobacterium tuberculosis and HIV, potentiate one another, accelerating the deterioration of immunological functions. Aims: To compare the clinical presentation of HIV-TB coinfection and TB infection and to study the correlation of CD4 count with the clinical, bacteriological and radiological findings of tuberculosis among HIV positive patients Materials and methods: This hospital based non randomised cross sectional observational study was conducted in 50 eligible patients admitted with tuberculosis and HIV coinfection and 50 patients with tuberculosis only in the medical wards. Study has been done to find relationship between CD4 count and the status of sputum smear. Results: In our study,26 cases(52%) had pulmonary tuberculosis at the initial diagnosis of HIV infection. Among the 26 cases, CD4 count less than 200 was present in 19(73.1%) . In our study , significant number of TB cases( 6 cases 12%) were diagnosed in the first year after HIV infection. Bilateral findings are 25% in both HIV-TB coinfection and TB infection whereas unilateral findings are 75% in both HIV-TB coinfection and TB infection. In HIV-TB coinfection lower zone findings are 17% whereas only 7% of TB infection has lower zones and there was a statistically significant. Conclusions: We concluded that sputum smear positivity decreases as the CD4 count decreases and sputum smear microscopy remains a gold standard method for diagnosing pulmonary tuberculosis.

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