Pulmonary Tuberculosis in Patients with HIV/AIDS in Iran

Pulmonary tuberculosis is still the most common form of tuberculosis in HIV infected patients having differ­ent presentations according to the degree of immunosuppression. This study appraised the impact of HIV infection on clini­cal, laboratory and radiological presentations of tuberculosis. The clinical, laboratory and radiological presentations of pulmonary TB in 56 HIV-infected patients were com­pared with 56 individually sex and age matched HIV-seronegative ones, admitted to Imam Hospital in Tehran (1999-2006) us­ing paired t-test in a case control study. All cases and the controls were male. Fever was found in 83.9% of the HIV positive patients compared to 80% of the HIV negative ones. Cough was the most common clinical finding in the HIV negative group (89.3% vs. 82.1% in HIV posi­tive group). Among radiological features, cavitary lesions, upper lobe and bilateral pulmonary involvement were ob­served significantly less often in the HIV-infected group. On the contrary, lymphadenopathy was just present in the HIV posi­tive group in this series of patients (12%) and primary pattern tuberculosis was more common, as well (71% vs. 39%, P= 0.02). The Tuberculin test was reactive in 29% of the HIV/TB patients. The coexistence of both infections alters the picture of tuberculosis in many aspects and should be taken into ac­count when considering a diagnosis of HIV infection and its potential for TB co-infection, and vice-versa.