We studied the seroprevalence of human immunodeficiency virus infection in patients with pulmonary tuberculosis and abdominal tuberculosis. We also assessed the clinical characteristics, risk factors, tuberculin status, site, and response to therapy of abdominal tuberculosis in human immunodeficiency virus (HIV)-seropositive and HIV-seronegative patients. Volunteer blood donors (n = 8,395), patients with pulmonary tuberculosis (n = 387), and patients with abdominal tuberculosis (n = 108) were screened for HIV 1 and/or HIV 2 by enzyme-linked immunosorbent assay (ELISA; Torrent, India) and positivity reconfirmed by a repeat ELISA and Western blot test. The HIV seroprevalence in the abdominal tuberculosis patients (16.6%) was significantly higher compared with those with pulmonary tuberculosis (6.9%, p < 0.05) and volunteer blood donors (1.4%, p < 0.01). Absolute lymphocyte counts did not differ between the HIV-seropositive and HIV-seronegative patients (2,044.94 +/- 830 vs 2,261.34 +/- 805/mm3, p = NS). The Mantoux reaction was larger in the HIV-seronegative group as compared with the HIV-seropositive group (14.8 mm vs. 9.5 mm, p < 0.05). Tuberculosis patients responded well to conventional antituberculosis drugs in standard doses regardless of their HIV status.
PIP: Human immunodeficiency virus (HIV) infection dramatically increases the risk of progression of latent tuberculosis infection. A case-control study conducted during 1992-95 at an urban teaching hospital in Mumbai, India, investigated the seroprevalence of HIV infection in patients with pulmonary and abdominal tuberculosis. Enrolled were 387 patients with active pulmonary tuberculosis, 108 with abdominal tuberculosis, and 8359 volunteer blood donors. The HIV seroprevalence rates in these 3 groups were 6.9%, 16.6%, and 1.4%, respectively. The majority of HIV-infected abdominal tuberculosis patients were in the early clinical stages of the disease and not significantly immunosuppressed. These patients had higher rates of lymphatic and hepatic tuberculosis than seronegative patients, suggesting disease dissemination. All tuberculosis patients, regardless of HIV status, responded well to antituberculous drugs in standard doses. These findings suggest that all patients with pulmonary and abdominal tuberculosis should be screened for HIV. In addition, long-term chemoprophylaxis in HIV-infected persons from tuberculosis-endemic areas should be considered.