The nature of tuberculosis
(TB), being one of the most common opportunistic infections, is different among
HIV-infected patients than HIV-negative patients.
A retrospective study was
conducted on HIV-positive and HIV-negative patients with new TB pleural
effusion who were admitted to the National Research Institute of Tuberculosis
and Lung Diseases in Tehran, Iran from 2005 to 2012.
The two groups were
compared with respect to clinical, imaging, mycobacteriologic and
histopathologic characteristics of TB pleural effusion. In all, 42 HIV-positive
and 132 HIV-negative cases of TB pleural effusion were included. Bilateral
pleural effusion was statistically more common in the HIV-positive group
(p = 0.004, OR = 3.81, 95% CI: 1.46-9.94) without any correlation with CD4 cell
count. Pulmonary infiltration was found in 81% of HIV-positive and 49.2% of
HIV-negative patients (p = 0.001, OR = 4.38, 95% CI: 1.88-10.1).
Mycobacteriologic studies led to the diagnosis of TB in 66.6% of HIV-infected
and 49.2% of HIV-negative patients. In 23.8% of HIV-positive and 50.7% of
HIV-negative patients TB was ultimately diagnosed by pleural biopsy. HIV
remained significantly associated with positive culture of pleural fluid in
multivariate analysis.
The diagnostic approach to TB pleural effusion in HIV-infected
patients may be different. The diagnostic yield of mycobacteriologic studies
was higher among HIV-positive patients, which may help in reducing the need for
invasive procedures like pleural biopsy.
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By:
- 1Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- 2Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran amir.yousefzadeh@gmail.com.
- 3Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- 4Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Int J STD AIDS. 2016 Apr;27(5):363-9. doi: 10.1177/0956462415581738. Epub 2015 May 8.
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