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A comparison of clinical features in tuberculosis associated with infection with human immunodeficiency viruses 1 and 2.

Abstract：

:Between July 1989 and December 1990, 4504 new adult patients with tuberculosis were screened for antibodies to human immunodeficiency viruses (HIV) 1 and 2 in Abidjan's 2 tuberculosis treatment centres. The prevalence levels of HIV-1 and HIV-2 infections were 30.2% and 4.2% respectively, a further 9.3% of patients reacting serologically to both viruses. Patients in all 3 seropositive groups differed significantly from seronegatives in having a higher frequency of AIDS-related features such as wasting, chronic diarrhoea, oral candidiasis and generalized lymphadenopathy. These data support earlier work showing an association between HIV-2 infection and similar opportunistic diseases which complicate HIV-1 infection, including tuberculosis. Despite the differences between seropositive and seronegative groups, symptoms and signs of tuberculosis may mimic those of AIDS. HIV testing should be more widely available for the clinical care of tuberculosis patients in Africa, as well as for epidemiological surveillance. :Tuberculosis (TB) is the most important opportunistic disease complicating HIV-1 infection in sub-Saharan Africa. Since the discovery of HIV-2, speculation has existed over how aggressively it leads to debilitating illness and the nature of its association with TB. If HIV-2 is associated with AIDS, one could expect TB to be a consequence of HIV-2 infection. Work in Cote d'Ivoire has shown an increased prevalence of HIV-2 infection in ambulatory TB patients. To gain insight into this potential association, the clinical, features of TB patients infected with HIV-1, HIV-2, and both are compared with those of seronegative persons. A total of 4504 new adult patients with tuberculosis were screened during 1989-90 for antibodies to HIV-1 and HIV-2 in Abidjan's tuberculosis treatment centers. 30.2% of the sample tested seropositive for HIV-1, 4.2% for HIV-2, and 9.3% to both. Individuals testing seropositive to either or both viruses had a significantly higher frequency compared with seronegatives of AIDS - related features like wasting, chronic diarrhea, oral candidiasis, and generalized lymphadenopathy. These findings definitely support earlier work demonstrating an association between HIV-2 infection and tuberculosis. It should be noted, however, that since the wasting and fever signs and symptoms of TB may mimic those of AIDS and that it is extremely difficult to distinguish between HIV+ and HIV- TB in Africa, blood testing for HIV is ultimately needed. Accordingly, HIV testing should be made widely available for the clinical care of TB patients in Africa as well as for epidemiological surveillance.

journal_name

Trans R Soc Trop Med Hyg

journal_title

Transactions of the Royal Society of Tropical Medicine and Hygiene

authors

Gnaore E,Sassan-Morokro M,Kassim S,Ackah A,Yesso G,Adjorlolo G,Digbeu H,Coulibaly D,Coulibaly IM,Doorly R

doi

10.1016/0035-9203(93)90420-u

keywords:

["Acquired Immunodeficiency Syndrome--prevention and control","Africa","Africa South Of The Sahara","Developing Countries","Diseases","Examinations And Diagnoses","French Speaking Africa","Hiv Infections--prevention and control","Infections","Ivory Coast","Laboratory Examinations And Diagnoses","Measurement","Physical Examinations And Diagnoses","Prevalence","Research Methodology","Tuberculosis","Viral Diseases","Western Africa"]

subject

Has Abstract,Author List Incomplete

pub_date

1993-01-01 00:00:00

pages

57-9

issue

eissn

0035-9203

issn

1878-3503

journal_volume

pub_type

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A comparison of clinical features in tuberculosis associated with infection with human immunodeficiency viruses 1 and 2.