HIV/AIDS-tuberculosis (pulmonary and extra pulmonary) co-infection: CD4 correlation


  • R. Siddeswari Department of Medicine, Osmania Medical College, Hyderabad, Telangana
  • K. S. Amaravathi Department of Medicine, Osmania Medical College, Hyderabad, Telangana
  • N. Srinivasa Rao Department of Medicine, Osmania Medical College, Hyderabad, Telangana
  • Sanjeev . Medical Officer, ART Centre, Osmania Medical College, Hyderabad, Telangana
  • B. Rewari Co-Ordinator, ART Centre, Osmania Medical College, Hyderabad, Telangana
  • Prabhu Kumar Department of Medicine, Osmania Medical College, Hyderabad, Telangana



HIV, Tuberculosis, CD4 count, Extra pulmonary tuberculosis, Opportunistic infection


Background: AIDS is the leading cause of death among people 15-59 years old in low income countries. Worldwide, approximately one-third of all AIDS-related deaths are associated with TB. TB is the primary cause of death for 10-15% of patients with HIV infection. So the present study was conducted to find the correlation between sputum positivity and CD4 cell count in patients with HIV/AIDS-Tuberculosis co-infection.

Methods: The present study was a retrospective hospital based study of patients with HIV/AIDS-Tuberculosis co-infection, attending ART centre, department of medicine, Osmania general hospital, Hyderabad, Telangana, India between November 2014 to September 2015. Data included clinical profile, complete blood picture, renal and liver function tests, sputum microscopy and C/S and chest X-Ray and others as and when required.

Results: We included 180 HIV/AIDS infected patients on ART with tuberculosis (TB) co-infection. Out of 180 patients, 132 were males and 48 were females. Among male’s ≥40 (51.51%) year’s age group and among females 30-39 (56.25%) year’s age group was the most commonly affected. Out of 180 cases 60 were sputum positive. 60 sputum negative pulmonary tuberculosis and 60 were extra pulmonary TB. CD4 cell count was <200/mm3 in 36 (60%) of sputum positive TB, 43 (71.7%) of sputum negative pulmonary TB & 39 (65%) of extra pulmonary TB patients. CD4 cell count was 200-400/mm3 in 16(26.7%) of sputum positive pulmonary TB, 13 (21.7%) of sputum negative TB and 19 (31.7%) of extra pulmonary TB patients. CD4 cell count was >400/mm3 in 8 (13.3%) of sputum positive pulmonary TB, 4 (6.6%) of sputum negative pulmonary TB and 2 (3.3%) of extra pulmonary TB patients.

Conclusions: Present study concludes that male sex and age group >30 years were the commonly affected population. All forms of tuberculosis were common when CD4 count was <200 cells/mm3. The sputum negativity was higher with lower CD4 counts.



Philip J. Peters, Barbara J. Marston, Kevin M. De Cock; SECTION 5 Viral Infections Chapter 9 HIV Epidemiology in the Tropics.Manson’s Tropical Diseases,23rd edition, Elsevier Limited;Pg 68-78.

Pneumocystis pneumonia – Los Angeles. MMWR 1981;30:250–2.

UNAIDS. 2006 Report on the global AIDS epidemic. Available at pub/ GlobalReport/2006/2006_grexecutivesummary_en.pdf.Last accessed on 18th October 2015.

Korber B, Muldoon M, Theiler J, Gao F, Gupta R, Lapedes A. Timing the ancestor of the HIV-1 pandemic strains. Science. 2000;288:1789-96.

UNAIDS. Report on the global HIV/AIDS epidemic 2008.Available: http://www. en/data analysis/epidemiology/2008_report_on_the_global_aids_epidemic/ (Accessed 5 May 2011).

World Health Organization. The global burden of disease: 2004 update. Available: 2004_report_update/en/index.html (Last accessed 18th october 2015).

Dlodlo RA, Fujiwara PI, Hwalima ZE, Mungofa S, Harries AD. Adult mortality in the cities of Bulawayo and Harare, Zimbabwe: 1979-2008. Journal of the International AIDS Society. 2011;14(Suppl 1):S2.

Fauci AS, Lane HC. Human Immuno deficiency Virus Disease: AIDS and Related Disorders; Harrison’s Principles of Intermal Medicine 19 edition. 2015;226:1215-85.

Seaton RA. Extra-pulmonary tuberculosis, Crofton and Douglas’s Respiratory diseases. Fifth Edition. 2000;18:535-52.

Leitch AG. Pulmonary Tuberculosis: Clinical Features, Ch7; Crofton and Douglas’s Respiratory Diseases. fifth edition. 2000;11:7:507-27.

Handwerger S, Mildvan D, Senie R, McKinley FW. Tuberculosis and the acquired immunodeficiency syndrome at a New York City Hospital, 1978–1985. Chest. 1987;91:176-80.

Hopewell PC. Reichman LB et al., Tuberculosis and infection with the human immunodeficiency virus. In New York, Tuberculosis.1993:369.

Pastores SM, Naidich DP, Aranda CP, McGuinnes G, Rom WN. Intrathoracic adenopathy associated with pulmonary tuberculosis in patients with Human Immunodeficiency Virus infection. Chest. 1993;103:1433-7.

Lucas SB, De Cock KM, Hounnou A, Peacock C, Diomande M, Hondé M, Beaumel A, et al. Contribution of tuberculosis to slim disease in Africa. Br Med J. 1994;308:1531-3.

Elliott AM, Namaambo B, Allen BW, Luo N, Hayes RJ, Pobee JO, et al. Negative sputum smear results in HIV positive patients with pulmonary tuberculosis in Lusaka, Zambia. Tubercle Lung Dis. 1993;74(3):191-4.

Ravi V, Desai A. HIV and AIDS, API textbook of medicine. 9E,16(2):1014-16.

Edwin N, Mathai D. Oppurtunistic infections, HIV and AIDS, API textbook of medicine, 9E, 16(7):1032-35.

World Health Organisation. Tuberculosis facts 2007.Available from hivtb.htm (Last Accessed on 2008 Jan 14).

National AIDS Control Organisation (NACO) – Estimation of HIV infection in India. Available at http:// facts_hivestimates.htm (Last accessed on 18th October 2015).

AIDS Profile:India. Available at ipc/ www/hivctry.html. (Last accessed on 18th October 2015).

Beck JS, Potts RC, Kardjito T, Grange JM. T4 Lymphopenia in patients with active pulmonary tuberculosis. Clin Exp Immunl. 1985:60:49-50.

Singhal M, Banavalikar JN, Sharma S, Saha K. Peripheral blood T lymphocytes subpopulation in patients with tuberculosis and the effect of chemotherapy. Tubercle. 1989:70(3):171-8.

Turret GS, Telzak EE. Normalisation of CD4+ T-lymphocyte depletion in patients without HIV infection treated for tuberculosis. Chest. 1994:105:1335-7.

Lucas SB, Hounnou A, Peacock C, Beaumel A, Djomand G, N'Gbichi JM, et al. The mortality and pathology of HIV infection in a West African city. AIDS. 1993;7:1569-79.

Badri M, Ehrlich R, Wood R, Pulerwitz T, Maartens G. Association between tuberculosis and HIV disease progression in a high tuberculosis prevalence area. Int J Tuberc Lung Dis. 2001;5(3):225-32.

Wood R, Maartens G, Lombard CJ. Risk factors for developing tuberculosis in HIV-1 infected adults from communities with a low or very high incidence of tuberculosis. AIDS. 2000;23(1):75-80.

Wilkinson D. Drugs for preventing tuberculosis in HIV infected persons. Cochrane Database Systematic Review 2000;(4):CD000171.

Pape JW, Jean SS, Ho JL, Hafner A, Johnson WD Jr. Effect of isoniazid prophylaxis on incidence of active tuberculosis and progression of HIV infection. Lancet. 1993;342:268-72.

Siddeswari R, Sudarsi B, Sanjeev, Suryanarayana B, Manohar S, Abhilash. HIV/Aids-Tuberculosis (pulmonary and extra pulmonary) co-infection: sputum positivity and Cd4 Correlation. International journal of scientific and research publications. 2015;5(2):1-4.




How to Cite

Siddeswari, R., Amaravathi, K. S., Rao, N. S., ., S., Rewari, B., & Kumar, P. (2016). HIV/AIDS-tuberculosis (pulmonary and extra pulmonary) co-infection: CD4 correlation. International Journal of Research in Medical Sciences, 4(4), 1035–1039.



Original Research Articles