Published: 2022-11-25

Clinical and laboratory profile of tuberculosis in HIV positive individuals

Sandhya Rani B., Varsha R. Bhandarkar, Prathvi Nandalike, Machandra Reddy


Background: Tuberculosis (TB), major public health problem in most of the developing countries. There is significant difference in the laboratory profile of tuberculosis in human immuno-deficiency virus (HIV) infected compared to immunocompetent host. Prompt diagnosis and treatment of tuberculosis in HIV infected will improve the morbidity and mortality associated with dual infection. Objectives of the research were: to study about the clinical profile of tuberculosis in HIV positive individuals; and also, to study about the laboratory profile of tuberculosis in HIV positive individuals.

Methods: Patients with HIV positive status who fulfill the inclusion and exclusion criteria and admitted in Adichunchanagiri hospital and research center, BG Nagara Mandya district, Karnataka India, during the period of January 2020 to June 2021.

Results: Fever was the most common symptom (92.8%). Most common manifestation was extrapulmonary TB (54%). TB meningitis was the most common extra pulmonary involvement seen in 28.67%. Amongst patients with pulmonary TB, 6.3% of cases were smear positive for AFB bacilli, 58% of cases had pulmonary infiltrates on chest X-ray. In all cases of extra pulmonary TB (EPTB) CD4T cell counts were <200 cells/μl.

Conclusions: Chest X-rays were atypical with more of lowerzone infiltrative lesions. Sputum acid-fast bacillus (AFB) is negative in most of the patients with pulmonary TB, however had sputum cartridge based nucleic acid amplification test (CBNAAT) positive status, hence sputum CBNAAT remains the gold standard investigation. Fluid analysis with ADA correlation holds good for the diagnosis of TB meningitis and tubercular pleural effusion.


Acid fast bacilli; Directly observed treatment short course, Multi drug resistant tuberculosis

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Narain JP, Raviglione MC, Kochi A. HIV associated tuberculosis in developing countries:Epidemiology and strategies for prevention. Tuberc Lung Dis. 1992;515-26.

WHO/Global Tuberculosis report 2017. 20th report. Switzerland. 2017. Available at: https://apps.who. int/iris/handle/10665/259366. Accessed on 24 October 2022.

Ministry of Health and Family Welfare. India TB report. RNTCP annual status report. New Delhi. 2018. Available at: index1.php?lang=1&level=1&sublinkid=4160&lid=2807. Accessed on 24 October 2022.

Getahun H, Gunneberg C, Granich R, Nunn P. HIV infection associated tuberculosis: The epidemiology and the response. Clin Infect Dis. 2010;50(3):S201-7.

Corbett EL, Watt CJ, Walker N, Maher D, Williams BG, Raviglion MC, Dye C. The growing burden of tuberculosis:global trends and interactions with the HIV epidemic. Arch Intern Med. 2003;163:1009-21.

Tripathy S, Menon P, Joshi DR. Preliminary observation on lymphocyte subpopulations in HIV positive and HIV negative tuberculosis patients in Pune, India. Indian J Med Res. 2000;111:195-8.

Corbett E, Marston B, Churchyard GJ, De Cock KM. Tuberculosis in Sub-Saharan Africa: Opportunities, Challenges, and Changes in the Era of Antiretroviral Treatment. London School of Hygiene and Tropical Medicine. 2006;367:926-37.

Dean GL, SG Edwards, NJ Ives, Gail M, EF Fox, Lesley N et al.Treatment of Tuberculosis in HIV-infected Persons in the Era of Highly Active Antiretroviral Therapy. AIDS. 2002;16:75-83.

Forssbohm M, Zwahlen M, Loddenkemper R, Rieder HR.Demographic Characteristic of Patients with Extrapulmonary Tuberculosis in Germany. Eur Respir J. 2008;31:99-105.

Harrison’s textbook of internal medicine, 20th ed. McGraw-Hill Inc. 2018;1357.

Swaminathan S, Sangeetha M, Arun Kumar N. Pulmonary Tuberculosis in HIV positive individuals. Ind J Tub. 2002;49:189.

Singhal M, Gupta NK, Kanwaria DK. Clinical Spectrum of Tuberculosis (Pulmonary, Extra Pulmonary and Disseminated) in HIV Patients and Its Relationship With Cd4 Counts. 2017;16(6):75-7.

Kandati J, Boorsu SK, Pathalapati R, Buchineni M. Bleached smear microscopy provides higher yield in diagnosing pulmonary tuberculosis. Int J Res Med Sci 2016;4:2193-6.

Anand K Patel, Sandip J Thakrar, Feroz D Ghanchi, Clinical and laboratory profile of patients with tb and hiv coinfection. Lung India. 2011;28:93-6.

Jaryal A, Raina R, Sarkar M, Sharma A. Manifestations of tuberculosis in HIV/AIDS patients and its relationship with CD4 count. Lung India. 2011;28(4):263-6.

Nzou C, Kambarami R, Onyango F, Ndhlovu C, Chikwasha. Clinical Predictors of Low CD4 Count Among HIV-Infected Pulmonary Tuberculosis Clients: A Health Facility-Based Survey. S Afr Med J. 2010;100:602-5.