Diagnosing active and latent tuberculosis among Iranian HIV-infected patients

Clin Respir J. 2018 Jan;12(1):62-67. doi: 10.1111/crj.12479. Epub 2016 Apr 27.

Abstract

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/mm3 . 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.

Keywords: HIV; active; intravenous drug use; latent; screening; tuberculosis.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Comorbidity / trends
  • Female
  • Follow-Up Studies
  • HIV Infections / epidemiology*
  • HIV Infections / virology
  • HIV*
  • Humans
  • Iran / epidemiology
  • Latent Tuberculosis / epidemiology*
  • Latent Tuberculosis / microbiology
  • Male
  • Mycobacterium tuberculosis / isolation & purification*
  • Prevalence
  • Prospective Studies
  • Sputum / microbiology*
  • Tuberculin Test
  • Tuberculosis, Pulmonary / epidemiology*
  • Tuberculosis, Pulmonary / microbiology