A STUDY OF ATYPICAL MANIFESTATIONS IN PULMONARY TUBERCULOSIS CORRELATING WITH CD4 COUNT IN HIV SEROPOSITIVE PATIENTS

N.B. SWAROOPRANI¹*, S. RAJKUMAR^2
1Department of Microbiology, Subbaiah Institute of Medical Sciences, Shivamogga, Karnataka, India
²Department of Medicine, J J M Medical College, Davanagere, Karanataka, India
* Corresponding Author : swaroopa.soppin@yahoo.co.in

Received : 07-02-2016     Accepted : 12-02-2016     Published : 28-02-2016
Volume : 8     Issue : 2       Pages : 728 - 730
Int J Microbiol Res 8.2 (2016):728-730

Keywords : HIV patients, pulmonary TB, CD4 count, x-ray lesions
Academic Editor : Sodani Sadhna, Gangania Pooja Singh, Ranjana Hawaldar, Said Mohamed Daboor, Bhanderi B. B.
Conflict of Interest : None declared
Acknowledgements/Funding : None declared
Author Contribution : None declared

Background: HIV infection is major risk factor for progression to active tuberculosis. The typical symptoms, upper lobe disease and sputum positive for AFB are seen in patients with CD4 T cell count above 200 cells/cu µl. Patients with impaired immunity usually have atypical clinical, radiographic features, extra pulmonary disease and disseminated disease. So, diagnosis requires thorough work up. Methodology: The impact of CD4 count on various manifestations of 50 HIV seropositive patients with tuberculosis was studied. Results: Majority of patients were in the age group of 30-40 yrs. 58% were males and 42% females. The most common form was pulmonary TB (76%) followed by Pleural effusion (26%). X-ray findings showed bilateral infiltrations in 38% cases; Mid and lower zone infiltration in 26% cases and upper zone in 14%. Majority were Sputum -ve (68%), only 32% were sputum +ve. Mean CD4 count being 146.6±88; Mean CD4 in sputum positive TB was 254.8±77 and sputum negative TB was 97.2±33.8 and extra pulmonary TB was 142.3±55.3. All patients with upper zone lesions in chest x -ray had CD4 > 200 cells/µl and 84.6% of patients with mid and lower zone lesions had CD4 count 50-200. Conclusion: CD4 counts correlated well with clinical profile of TB, which showed that when CD4 counts were < 200 cells/µl , sputum negative pulmonary TB and disseminated pulmonary TB were more common. Chest x-ray were atypical in the form of lower zone involvement and more of infiltrative lesion..