Clinical manifestations and outcome of mycobacterium tuberculosis among HIV/AIDS patients

Abstract

The most explosive AIDS pandemic in ASIA and the world are India and Thailand while the most common opportunistic infection among HIV patients in most developing countries like Thailand is tuberculosis (TB). A one year retrospective study was done in Bamrasnaradura Hospital, Nonthaburi Province, Bangkok, Thailand among 271 subjects with dual infections of TB and HIV. The most common clinical manifestations were cough, weight lost, low grade fever, lymphadenopathy and chest infiltrates. These findings were also frequent manifestations of several other opportunistic infections other than TB and HIV. Disseminated TB occurred in 45.4% followed by pulmonary (35.4%) and extra-pulmonary TB (19.2%). Drug resistance to anti-TB regimen was quite alarming particularly MDR-TB (26.7%). MDR-TB among HIV patients was associated with past history of anti-TB treatment (p=0.005), disseminated TB (p=0.022) and mortality (p=0.013). Clinical outcome showed that lost to follow-up occurred in 46.7% and death in 13.3%. Among those who survived, only 11.4% was successfully treated while the rest did not improve because of relapsed (2,9%) and failure (8.8%) while the remaining 5.9% were continuing treatment and another 10.7% had incomplete treatment.