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RMU

Uruguayan Medical Journal

ISSN: 1688-0390


Vol.23 - Nº 3 - Set. 2007

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Tuberculosis in patients with Human Immunodeficiency Virus (HIV): diagnosis and variables to be considered to iniciate an empirical antituberculosis treatment

CABRERA S; MEDINA JC; SALABERRYBORDA AM; LIBRÁN MJ; GONZÁLEZ HM; SAVIO E
Rev Med Urug 2007; 23: 164-172
Full text (spanish) |  Full text (spanish) (New windows, pdf) | Abstract

Abstract

Background: coexistence of HIV and tuberculosis (TB)

difficults TB diagnosis and delays indication of specific

treatments. In order to identify variables that complicate

TB diagnosis we conducted a review of empirical antitu-

berculosis treatments iniciated five years ago in the Infec-

tious Diseases Department (Cátedra de Enfermedades

Infecciosas).

Methods: a descriptive retrospective study.

Definitions: confirmed TB: Mycobacterium tubercu-

losis culture. Highly probable TB: granuloma or caseum in

cytology/histopathology or bacilli positive. Probable TB:

fever remission 15 days before start of treatment and pa-

tient alive at discharge. Not confirmed TB or no TB: not

reach any of the above criteria or explicit other diagnosis.

Group A: confirmed TB and highly probable TB; group B:

probable TB.

Results: ninety-two patients were included in the study.

Group A: 82% (n = 75), they were considered as truly TB.

A significative difference was recorded at the CD4 level

between group A and B, 234 + 120 cells/ml and 94 + 72

cells/ml respectively (p = 0.0007).

A group of variables determine the start of the empiri-

cal treatment in most of the patients: associated prolonged

fever, respiratory clinic and compatible imaging were the

most frequent.

Conclusions: severe immunodepression difficults de-

finitive diagnosis of TB. The identification of variables

allows the start of empirical antituberculosis treatment in

patients with HIV with a high score of posterior success.