Source: International Congress 2015 – Case series and clinical conundrums in TB
Disease area: Respiratory infections

Abstract

Tuberculosis (TB) is one of the most common diseases and appears to become the most frequent cause of death in HIV persons all over the world. TB can occur anytime during HIV infection regardless of CD4+T-cells counts unlike the majority of opportunistic diseases.Herewith, acutely progressive, generalized and disseminated TB forms are specific for patients with severe immunodeficiency. Many researches provide evidence that TB morphology loses its specific features with the decline of CD4+ T cell counts to below 200/mL and clinical presentation appears to be atypical.The study aimed to learn clinical and morphological features of HIV/TB co-infection.We have analyzed data of medical cards, autopsy and histological studies reports of 116 patients (52 HIV-positive and 64 HIV-negative) died of TB in the Gomel region. Median CD4 + T cells level was 48 (2-233)/mL in HIV-TB patients.Average TB disease duration inHIV-patients, mostly aged from 26 to 45, was 1.8±1.1 years. Generalized TBdisease with multiorgan involvement was found to be the cause of death in 92.3% HIV-patients. Liver (84.6%), spleen (88.5%) and kidneys (65.4%) were found to be the most common extrapulmonary TB localization. TB meningitis (34.6%) and lymphadenopathy (38.5%) were detected in HIV patients only. Chronic TB intoxication symptoms (weight loss, parenchymatous viscera degeneration, kidney proteinosis, liver and spleen amyloidosis) were revealed to be significantly less common.Rapid TB disease progression in HIV-co-infected young people leads to generalization followed by death. The problem is of current importance for further research in order to get it effectively controlled.


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Nkolaj Burinsky (Gomel, Belarus), Nikolaj Burynski, Irina Buynevich, Roman Loginov, Svetlana Goponyako, Elena Demidova. Clinical and morphological features of HIV-associated tuberculosis. Eur Respir J 2015; 46: Suppl. 59, 2755

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