Pattern of active pulmonary tuberculosis in human immunodeficiency virus seropositive adult patients in University College Hospital, Ibadan, Nigeria

Abstract

Filly-eight confirmed HIV-seropositive adult patients were studied. All subjects were interviewed and examined. Subjects with positive respirator)' symptoms and signs had their sputum examined and cultured for Mycobacterium tuberculosis (M. tuberculosis). Their chest radiograph, full blood count (FBC) and erythrocyte sedimentation rate (ESR) were also estimated. Subjects with Pulmonary tuberculosis were treated using directly observed therapy short course (DOTS) regimen. Sixty-three percent of subjects were positive for Mycobacterium tuberculosis on direct smear and/or culture. Sputum acid fast bacilli (AFB) positive subjects who completed the intensive phase of antituberculosis drugs were sputum converted at 2 months. The chest x-ray finding at diagnosis showed 2 subjects (11%) with normal chest x-ray; localized lesion in 7 (37%) subjects; diffuse lesion in 7 (37%); pulmonary cavities in 3(16%); miliary pattern in 2(11%); pleural effusion in 2(11%); hilar adenopathy in 2(11%). Repeat chest-x-ray at 3 months showed complete clearance of pulmonary infiltrates in 29% whilst 71% had appreciable improvement in radiologic features. The study showed that although chest x-ray may be "normal" in sputum AFB positive HIV infected individuals, radiologic picture tends to be more diffuse and extensive. This study was therefore undertaken to determine the pattern of PTB in HIV seropositive adult patients in U.C.H., Ibadan.