The risk of tuberculosis disease among HIV infected patients after 2 years of follow up

Background: The risk of developing Tuberculosis (TB) disease is considered to be up to 7-10% each year for persons who are infected with both Mycobacterium tuberculosis (MTB) and HIV, whereas it is of 10% over a lifetime for persons infected only with MTB. The aim of the study was to assess the risk of TB disease among HIV infected persons, based on different clues for tuberculosis9 positive diagnosis, in a TB burden area, Constanta County. Design: Prospective study started in 01 February 2009, ended in 31 January 2011. Material and methods: Evaluation for TB disease diagnosis was done in 51 HIV patients with initiated active antiretroviral therapy (HAART) after 1996 and included medical history, physical examination, Mantoux Tuberculin skin test, chest X-ray, Bactec 9050 blood culture results, bacteriological exam (Acid Fast Stains smear and Lowenstein Jensen cultures). All 51 HIV infected patients were monitored 2 years in order to diagnose the active TB diseases. Results: The study includes 51 HIV infected people, 22 male and 29 female, mean aged 20.5 yrs. The age of HIV infection range was between 6 months to 20 years. The risk of developing TB disease was of 21.5% (n=11/51). The prevalence of Pulmonary TB disease was greater (n=9/11;80%) than extrapulmonary forms. The symptoms of high fever, chronic cough, weight loss and dispnoea were more persistent and more severe for HIV infected patients. Tuberculin skin testing and chest X-ray evaluation were helpful for diagnosis. Only one case had positive bacteriological exam. Conclusions: The risk of developing active TB diseases at HIV infected people is much higher than studies reported. The bacteriologic exam is less helpful for TB diagnosis.