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      Prevalence of Pulmonary Tuberculosis Among HIV Positive Patients Attending Antiretroviral Therapy Clinic

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          Abstract

          Background:

          Tuberculosis (TB) is the most common serious opportunistic infection in HIV positive patients and is the manifestation of AIDS in more than 50% of cases in developing countries. TB can occur at any time during the course of HIV infection.

          Aim:

          To describe the socio-demographic profile and prevalence of pulmonary tuberculosis (HIV/TB co-infection) among HIV positive patients been attended at the antiretroviral therapy clinic (ART) clinic at tertiary care teaching hospital of western Maharashtra, India.

          Materials and Methods:

          A cross-sectional study was carried out at the ART clinic of Pravara Rural Hospital, Loni, from June 2011 to May 2012. A total of 1012 HIV positive patients, who attended ART clinic, receiving ART treatment during the study period, were included in the analysis. The statistical analysis was performed using SPSS software (Version 17.0).

          Results:

          This study showed 1012/172 (17%) prevalence of pulmonary tuberculosis among HIV positive patients, of which 87 (50.58%) were males and 85 (48.42%) were females. Low CD4 count (< 50/μl) had statistically significant association with HIV/TB co-infection as compared to HIV infection only ( P < 0.0001).

          Conclusion:

          The study showed that 17% of HIV infected persons had tuberculosis co-infection. More strategic preventive measures that enhance body immunity among HIV patients are highly needed as early as possible before they develop active tuberculosis.

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          Most cited references28

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          World Health Organization.

          Ala Alwan (2007)
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            Medication Adherence and its Determinants Among Patients on Concomitant Tuberculosis and Antiretroviral Therapy in South West Ethiopia

            Background: To benefit from therapy and to avoid contracting treatment resistant strains, the individuals must adhere to medications. Aim: The study was designed to assess the degree of drug adherence and its determinants in patients living with HIV/AIDS and TB comorbidity. Materials and Methods: A cross-sectional study was conducted to assess the degree of drug adherence and its determinants with the help of self-administered questionnaires in Tercha District Hospital in South Ethiopia. Result: A total of 24 patients were included in the study. The majority were females (54.2%) and the mean age was 32.4 (SD±9.6) years. Adherence level was 95.8% for Antiretroviral (ARV) medications and 79.2% for anti TB medications. Educational status was associated with anti TB (P=0.021) medication adherence. The reason for the missed doses were mostly lack of money for transport (23.7% for antiretroviral therapy (ART), 26.0% for TB treatment) and forgetting to take medications (18.4% for ART, 17.4% for TB treatment. Conclusion: The adherence level obtained for both ARV and anti-TB where high. Transportation costs for patients could be reduced by bringing the services close to where they live.
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              HIV-Tuberculosis: A Study of Chest X-Ray Patterns in Relation to CD4 Count

              Background: Fight against human immunodeficiency virus (HIV) is incomplete without addressing problems associated with difficult diagnosis of tuberculosis in HIV-Tuberculosis coinfected patients. Chest X-ray is a primary tool to evaluate tuberculosis in HIV. Aim: To assess and compare various radiological patterns of pulmonary tuberculosis in HIV patients and compare these patterns in relation to CD4 counts. Materials and Methods: Prospective cohort study was conducted in a tertiary hospital in South India from September 2009 to July 2011 with 200 HIV positive patients. WHO guidelines were used for diagnosis of HIV and tuberculosis. Results: 27% of the patients had sputum positive pulmonary tuberculosis, with higher incidence (33%) among CD4 less than 200 as compared to CD4 more than 200 (14%). Infiltration (39%) followed by consolidation (30%), cavity (11%), and lymphadenopathy (9%) seen with CD4 less than 200. Infiltration (37.5%) followed by cavity (25%) and miliary (25%) with CD4 above 200. Bilateral (68.5%) and mid and lower zones or all zone involvement more commonly seen. Conclusion: In patients with CD4 lower than 200 noncavitory infiltration and consolidation predominated. Involvement of lungs was atypical; diffuse or mid and lower zone involvement than classical upper lobe involvement. A high index of suspicion is necessary for the accurate and timely diagnosis of tuberculosis in HIV positive patients.
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                Author and article information

                Journal
                N Am J Med Sci
                N Am J Med Sci
                NAJMS
                North American Journal of Medical Sciences
                Medknow Publications & Media Pvt Ltd (India )
                2250-1541
                1947-2714
                June 2013
                : 5
                : 6
                : 367-370
                Affiliations
                [1] Department of Community Medicine, Rural Medical College and Pravara Rural Hospital, Loni, Maharashtra, India
                Author notes
                Address for correspondence: Dr. Purushottam A. Giri, Department of Community Medicine, Rural Medical College of Pravara Institute of Medical Sciences (Deemed University), Loni, 413 736, Maharashtra, India. E-mail: drpgiri14@ 123456gmail.com
                Article
                NAJMS-5-367
                10.4103/1947-2714.114169
                3731868
                23923111
                8b92d1ad-5d25-4b15-842e-3db0c7fed04d
                Copyright: © North American Journal of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Original Article

                Medicine
                antiretroviral therapy clinic,hiv infection,prevalence,pulmonary tuberculosis
                Medicine
                antiretroviral therapy clinic, hiv infection, prevalence, pulmonary tuberculosis

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