Diagnosing active and latent tuberculosis among Iranian HIV-infected patients

作者：Baghaei Parvaneh; Esmaeili Shahrbanou; Farshidpour Maham; Javanmard Pedram; Marjani Majid; Moniri Afshin; Nemati Kambiz; Tabarsi Payam^*

来源：Clinical Respiratory Journal, 2018, 12(1): 62-67.

DOI：10.1111/crj.12479

• active
• HIV
• intravenous drug use
• latent
• screening
• tuberculosis

Objective: To screen for Tuberculosis (TB) in human immunodeficiency virus (HIV) people in an effort to improve early TB diagnosis and reduce TB transmission.
Methods: A prospective study was conducted on adult HIV people from 2008 to 2011. Three samples of sputum, cell blood count, tuberculin skin test (TST) and chest X-ray were obtained from all patients. The characteristics of HIV patients with TB and HIV patients without TB were compared to each other.
Results: Of the 154 HIV patients included, 58 (38%) had tuberculosis with a mean CD4 cell count of 68 cells/mm(3). Active TB was found in 56 (47%) patients with a history of intravenous drug use. Cough (OR=3.1, 95% CI 1.2-7.79), positive TST (OR=8.15, 95% CI 3.28-20.25) and an abnormal chest X-ray (OR=5.1, 95% CI 1.84-14.2) were the predicting factors for detecting active TB among HIV patients. The sensitivity and specificity of a combination of any symptoms with chest X-ray, smear, TST or all of these were 96.5% and 86.5%, respectively. CD4 cell count <100 (OR=2.67; 95% CI 1.23-5.78) and smoking (OR=13.4; 95% CI 3.04-59.4) remained independently associated with TB in a multivariate analysis.
Conclusion: There was a high prevalence of TB within the HIV population. Screening for TB among these patients can be carried out at every clinic or health facility using a combination of symptoms, TST, chest X-ray and smear sample.

• 出版日期2018-1