Clinical Manifestations and Outcome among Acquired Immune Deficiency Syndrome (AIDS) Patients with Mycobacterium Tuberculosis

Abstract

Introduction: The most explosive HIV-AIDS pandemic areas in Asia and the world are India and Thailand while the
common opportunistic infection in most developing countries is Tuberculosis (TB). The risk of tuberculosis disease
progression is about 100 times greater in HIV sero-positive than in sero-negative people, and the mortality rate is about four
times greater in HIV positive people with tuberculosis than in HIV negative people with tuberculosis.
Objectives: The objective of this study was to determine the clinical manifestations and outcome among AIDS patients with
Mycobacterium tuberculosis infections.
Methods: This retrospective study was conducted at Bamrasnaradura infectious disease hospital Thailand, in which patients
were identified for a period of six months and then followed up for the next six months. Adults from both sexes 16 years old
and above diagnosed as AIDS-TB included in study. All the data collected by questionnaire was recorded, keyed, edited and
analyzed by using Epi info 6 software and data is presented by: median and range for quantitative variables, frequency and
percentage for qualitative variable.
Discussion: A series of studies have been conducted in Thailand regarding tuberculosis with AIDS. Most studies showed
tuberculosis as either the first or second most common opportunistic infection among AIDS patients. A high mortality of
about 30% seen among AIDS patients with tuberculosis was reported in one study. Sixteen months is reported as the mean
survival time among these cases.
Results: In this study the most common clinical features observed were fever, loss of weight, and loss of appetite, cough, and
enlarged lymph nodes. Oral candidasis is most frequently occurring opportunistic infection. PPE was a very common
cutaneous manifestation. Streptomycin found to be the most frequent resistant drug.
Conclusion: The majority of cases belong to the age group, which is socially and sexually active. Involvement of this group
leaves a major impact on social and economical well being of the country as well as they play an important role in
transmission of TB and AIDS. Lost of follow-up rate is very high and majority lost follow-up with in first month, an
important factor in occurrence of drug resistance.