Current characteristics of tuberculosis (TB) and human immunodeficiency virus (HIV) coinfection in a cohort of hospitalized patients in Medellín, Colombia / Características actuales de la coinfección con tuberculosis y el virus de la inmunodeficiencia humana en pacientes hospitalizados en Medellín, Colombia

ABSTRACT: Introduction: Tuberculosis (TB) is an important cause of morbidity and mortality in HIV patients. It is unknown if the advent of molecular diagnostic methods and a greater availability of antiretroviral therapy (ART) in our country have changed some characteristics of the TB/HIV co-infection. Objective: To describe the epidemiology, clinical features, diagnosis, resistance patterns, tuberculosis drug effects and mortality in co-infected patients. Materials and methods: Retrospective study based on the review of medical records of hospitalized co-infected adults in a university hospital in Medellín, Colombia. Results: A total of 178 patients was included in the study. TB and HIV diagnosis was simultaneous in 49.4%. In the moment of TB diagnosis, the median CD4 count was 61 cells/μL (27-145). Pulmonary tuberculosis (PTB) occurred in 28% of patients, extrapulmonary (EPTB) in 23%, and mixed TB in 48.9%. The main EPTB affectations were lymphatic (55.4%), gastrointestinal (35.9%), and of the central nervous system (18.7%). Ziehl-Neelsen stain was positive in 137 patients (77%), mycobacterium culture in 121 (68%), and TB-PCR, in 85 of those patients in whom the test was done. Rifampicin resistance was detected in six cases (4.9%). Transaminases (ALT) increased in half of the patients during TB treatment, but only 10% met liver-toxicity criteria. In-hospital mortality was 11.3%. The single risk factor associated with mortality was CD4 count <50/μL (RR=3.9; 95% CI: 1.36-11.37; p=0.01). Conclusions: When it occurs as an opportunistic infection, TB usually leads to the diagnosis of advanced HIV disease. If used appropriately, TB diagnosis in these patients can be done by conventional methods. It is always necessary to monitor liver function during TB treatment and to rule out drug resistance.

• Autores: Ruiz Sosa, Lina; Maya Restrepo, María Angélica; Rueda Vallejo, Zulma Vanessa; López López, Lucelly; Vélez Giraldo, Lázaro Agustín
• Tipo de recurso: Article of investigation
• Fecha de publicación: 2018
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/37995
• Acceso en línea: https://hdl.handle.net/10495/37995
• Palabra clave: Tuberculosis; VIH; HIV; Resistencia a Medicamentos; Drug Resistance; Técnicas de Diagnóstico Molecular; Molecular Diagnostic Techniques; Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos; Drug-Related Side Effects and Adverse Reactions; Síndrome de Inmunodeficiencia Adquirida; Acquired Immunodeficiency Syndrome; https://id.nlm.nih.gov/mesh/D014376; https://id.nlm.nih.gov/mesh/D006678; https://id.nlm.nih.gov/mesh/D004351; https://id.nlm.nih.gov/mesh/D025202; https://id.nlm.nih.gov/mesh/D064420; https://id.nlm.nih.gov/mesh/D000163
• Rights: openAccess
• License: http://creativecommons.org/licenses/by-nc-nd/2.5/co/