Tuberculosis in HIV/AIDS Patients

Background: In Albania the incidence of people with both TB and HIV is small; however, it is a category that should not be neglected. Objective: The main aim of the study is to assess the characteristics of TB in the HIV/AIDS patients. Methods: During 2004-2015 years are studied 77 HIV/AIDS patients with pulmonary complications from which in all resulted 27 (32.2%) cases of TB, 23 (85.2%) cases as pulmonary tuberculosis and 4 (14.2%) cases as generalized tuberculosis. Results: The average age of the subjects with pulmonary TB and generalized TB was respectively 48.1 ± 9.8 and 47.8 ± 10.2 years, males –22 (95.7%) and 2(50%), smokers – 21 (91.3%) and 4 (100%), urban residents 16 (69.6%) and 3 (75%), unemployed – 9 (39.1%) and 1 (25%). Period of knowing HIV infection was respectively 6.2 ± 2.2 and 4 ± 2.2 years, period of ART treatment - 5.3 ± 2.8 and 2.9 ± 3. According to the count of CD4 cellules, 6 (26.1%) patients with pulmonary TB resulted with 200-999 cells/ml, 8 (34.8%) - with 100-199 cells/ml and 9(39.1%) <100 cells/ml and all generalized TB patients with <100 cells/ml. Clinical manifestation of pulmonary TB only were: cough – 73.9%, expectoration- 43.5%, dyspnoea – 34.8%, chest pain – 26.1%, haemoptysis – 26,1%, weight loss – 65.2%, fatigue – 87%, fever – 78.3%, anorexia- 78.3%; chest radiograph showing evidence of adenopathy in 5 (21.7%) cases and with CT in 7 (30.4%) cases. Lesions localised on the right lung in 5 (21.7%) cases, on the left- 8 (34.8%), and bilateral –10 (43.5%). Upper zone localization was in 13 (56.5%) cases, middle zone – 7 (30.4%) and lower zone–3 (13%). During the study died 4 (17.4%) of patients with pulmonary TB, 3 patients with 100-199 CD4 cells/ml and one patient with <100 CD4 cells/ml and 3 (75%) of patients with generalized TB all with <100 CD4 cells/ml. Conclusion: TB is a common respiratory complication with high mortality rate in HIV/AIDS patients. The level of CD4+ count is predictive factor for clinical manifestation and prognosis.

Author(s): Matilda Gjergji, Jul Bushati, Arjan Harxhi, Hasan Hafizi and Pellumb Pipero

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