HIV/tuberculosis co-infection: the association of sociobiological and immunological characteristics with the clinical presentation of tuberculosis
A.M. Brito1,2, H. Corrêa de Araújo3, M.D.F. Pessoa Militão de Albuquerque1, A. Paula da Silva4, M.M. Melo de Barros Oliveira4, L.C. Rocha Vilela Moura5, R. Arraes de Alencar Ximenes2,5
1Fundação Oswaldo Cruz, Centro de Pesquisas Aggeu Magalhães, Recife, Brazil, 2Universidade de Pernambuco, Faculdade de Ciências Médicas, Recife, Brazil, 3Universidade Federal de Pernambuco, Centro de Ciencias da Saúde, Recife, Brazil, 4Secretaria de Saúde de Pernambuco, Hospital Correia Picanço, Recife, Brazil, 5Universidade Federal de Pernambuco, Departamento de Medicina Tropical, Recife, Brazil
Background: The HIV infection interferes in the clinical characteristics of tuberculosis, once the location where tuberculosis appears is related with the immunological state of the individual. It can vary from the classic pulmonary tuberculosis to uncommon manifestations of the pulmonary tuberculosis and appearances of extra-pulmonary tuberculosis in the later stages of immunodeficiency.
Methods: This study was developed to analysis the association of sociobiological and immunological characteristics with the clinical presentation of tuberculosis of the comorbid cases identified in an infectious Hospital in Recife, Pernambuco, Brazil, from August 2008 to December 2009.
Results: A total of 199 patients were included, 30,1% of them being given the diagnosis of extra-pulmonary tuberculosis. The patients were predominantly males (72,4%), over 35 years of age (61,2%), non drinkers (72,9%), smokers (60,3%), with CD4 lymphocytes count over 200 (41,4%); most of them started knowing about their disease in the last 5 years and are in use of the anti-retroviral therapy. The association of the independent variables with the clinical type of tuberculosis (pulmonary versus extra-pulmonary) showed an statistically significant association between extra-pulmonary tuberculosis and the CD4 lymphocytes count being below 200 before (χ2 =43,18, p< 0,05), and the pulmonary type of tuberculosis was associated with the habits of smoking and drinking (χ2 =5,17, e 5,71,respectively; p< 0,05).
Conclusions: The association between extra-pulmonary tuberculosis and the immunodeficiency is the same as shown in other existent works that shows a bigger prevalence of extra-pulmonary tuberculosis in patients co-infected with the HIV when compared with patients that have only tuberculosis, and also shows an even bigger prevalence of extra-pulmonary tuberculosis when looking at patients in a more severe state of immunodeficiency.
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