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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We conducted a case-control study to determine the relative and attributable risk of HIV seropositivity for bacillary-positive (smear and/or culture) pulmonary tuberculosis in Haiti. There were 274 patients with tuberculosis and an equal number of control subjects. Antibodies to HIV were present in 67 (24%) patients and eight (3%) control subjects. Odds ratios suggested that the risk of pulmonary tuberculosis was 15.7 times as great (95% confidence interval, 4.8 to 5.0; p less than 0.05) in patients 20 to 39 yr of age who were HIV-seropositive than in HIV-seronegative patients. In contrast, the relative risk in those 40 to 59 yr of age was elevated (3.0 times), though not significantly (lower 95% confidence interval, 0.8). In the 20- to 39-yr age group, 31% of tuberculosis was attributable to HIV infection (95% confidence interval between 23 and 39%). HIV-seropositive and HIV-seronegative patients did not differ with respect to sputum smear positivity. HIV-seronegative patients were twice as likely to be infected with resistant organisms, though this was not significant. We conclude that HIV infection is a major risk factor for pulmonary tuberculosis in young adult residents of Haiti. This, together with the fact that similar proportions of HIV-seropositive and HIV-seronegative patients were potentially infectious, suggests that without vigorous counteraction tuberculosis will become a greater problem for Haiti.
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PMID:Impact of human immunodeficiency virus type 1 on tuberculosis in rural Haiti. 189 47

In rural Haiti we measured and compared the muscle protein and calorie reserves (anthropometrics) as well as the visceral protein reserves (serum albumin, tuberculin sensitivity) in 56 HIV (human immunodeficiency virus type-1) seropositive and 108 HIV seronegative pulmonary tuberculosis patients. Results in patients were also compared to the results of the same measurements made in 160 age, sex and residence matched HIV seronegative controls without tuberculosis. Tuberculosis patients, regardless of HIV status, had significantly reduced muscle protein and calorie reserves compared to controls. The serum albumin was significantly lower in HIV seropositive tuberculosis patients (21.0 g/l) compared to HIV seronegative tuberculosis patients (26.9 g/l) and the serum albumin in both tuberculosis groups was significantly lower than in controls (41.3 g/l). The lower the serum albumin in the tuberculosis patients the greater the likelihood of a negative tuberculin test. HIV seropositive tuberculosis patients were significantly more likely to be tuberculin negative than HIV seronegative tuberculosis patients. Tuberculosis is associated with significant malnutrition. Worse malnutrition in tuberculosis patients co-infected with HIV suggests that the effect of the two pathogens on nutrition is additive or, alternatively, that tuberculosis patients who are particularly malnourished are at increased risk for HIV.
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PMID:Pulmonary tuberculosis, human immunodeficiency virus type-1 and malnutrition. 190 8

In a developing country, 289 patients were examined for active pulmonary mycobacterial disease (sputum smear and culture) and HIV infection (serology) to compare the sensitivity and positive predictive value of sputum smears for diagnosing pulmonary tuberculosis in patients with and without antibodies to HIV. Seventy-nine percent of HIV-seronegative vs 66% of HIV-seropositive patients with positive cultures for Mycobacterium tuberculosis were smear positive (P less than .05), and a positive sputum smear predicted the presence of M. tuberculosis in 90% of HIV seronegative vs 80% of HIV seropositive patients (P less than .05). In our opinion, HIV did not significantly compromise the diagnostic utility of the sputum smear.
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PMID:The impact of HIV on the usefulness of sputum smears for the diagnosis of tuberculosis. 192 36

At the fall of 1989 a questionnaire was sent to 19 institutions particularly involved with AIDS. 17 (89 percent) responded at all, 11 (and one more additionally) delivered qualified data. Overall 8,518 persons with proved HIV infection of different stages were treated from 1987 to 1989 in institutions distributed over the whole Federal Republic and Westberlin. 94 of the HIV infected suffered from tuberculosis. The risk of tuberculosis was approximately equally high for males and females. It was elevated by the factor 7 to 11 in the early stages of the HIV infection (CDC-classification). The factor was 157 in stage IVB-E (AIDS). The risk was higher for male homo- or bisexuals compared with iv drug users. The rate of tuberculosis did not significantly increase from 1987 to 1989. There were much more cases with multiple sites or of extrapulmonary localisations, especially of peripheral lymph nodes in males and an unusual high percentage of bacteriological confirmation of cases with respiratory tuberculosis with an uncommonly low rate of positive sputum smears. Up to now epidemiology of tuberculosis in the Federal Republic will not be in general markedly influenced inspite of the high risk of HIV infected.
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PMID:[HIV infection and tuberculosis--result of a survey]. 194 52

A 33-year-old man with AIDS and pleuro-pulmonary tuberculosis was treated with a combination of antituberculous medications for 12 months and with continuation of isoniazid. A total of 2 months after completing combination therapy the patient developed fever, malaise, and anorexia. Mycobacterial blood cultures grew M. tuberculosis and the patient improved with the readministration of rifampicin and pyrazinamide. Phage typing of the patient's isolates of M. tuberculosis confirmed that he had experienced a relapse and not a reinfection. The patient had received 5 months of his treatment while hospitalised. We believe he was compliant with therapy outside the hospital because he attended all of his clinic appointments. Follow-up studies of HIV-infected patients with tuberculosis are therefore needed.
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PMID:Relapse of tuberculosis in a patient with the acquired immunodeficiency syndrome despite 12 months of antituberculous therapy and continuation of isoniazid. 194 19

Sixteen human immunodeficiency virus type 1 (HIV-1)-seropositive children aged 5 to 12 years (nine girls and seven boys), born to HIV-1-infected mothers, were diagnosed between 1984 and 1987 in Kigali, Rwanda. They were compared with a group of age- and sex-matched HIV-1-seronegative children consecutively selected from the outpatient department. Two subjects were asymptomatic. Chronic cough was the most frequent symptom (seven of 16 patients). The most common signs were short stature (12 of 16 patients), low weight for age (seven of 16 patients), chronic parotitis (eight of 16 patients), persistent generalized lymphadenopathy (seven of 16 patients), and pulmonary tuberculosis (four of 16 patients). Lymphoid interstitial pneumonitis was diagnosed on radiologic grounds in five of 16 patients. Evidence of perivasculitis in the fundus was noted in three of 16 patients. Two children died during the study period (mean duration of follow-up, 40 months; range, 27 to 62 months); none of the other children had life-threatening infection or loss of developmental milestones. Immunologic assessment in the 16 children revealed high levels of IgG, decreased CD4+/CD8+ ratio, and skin test anergy. Endocrinologic investigations revealed normal thyroid function and normal basal human growth hormone levels but low basal insulinlike growth factor I levels (0.21 +/- 0.07 vs 0.44 +/- 0.20 U/mL for controls). In Kigali, perinatally HIV-1-infected children surviving beyond 5 years of age often present with moderate signs and symptoms, principally pulmonary involvement, chronic parotitis, and persistent generalized lymphadenopathy. Short stature is the major clinical manifestation in these patients and may be due, in part, to low growth hormone secretion rather than to malnutrition.
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PMID:Clinical and endocrinologic manifestations in perinatally human immunodeficiency virus type 1--Infected children aged 5 years or older. 195 Dec 15

Estimates show that 5 million people worldwide are infected with human immunodeficiency virus (HIV). Recent estimates are that 8-10 million new tuberculosis (TB) cases occur each year in the world. 2-3 million die. In developing countries, TB is one of the most common opportunistic infections in people who are seropositive for HIV-1. About 90% of the TB is pulmonary. Of those without pulmonary tuberculosis, 85% had lymphadenopathy, bone and joint disease, or pleural effusion. In adults and children over 15 who had pulmonary TB, 78% had positive sputum smears for acid-fast bacilli. 66% had cavitation on chest radiography. Many people with TB and HIV infection have typical clinical and radiologic features. However, African clinicians have seen a change. This makes TB harder to diagnose. In Bangui, Central African Republic, 30% of pulmonary TB patients were HIV seropositive. Studies from Zaire and Zambia also had patients with suspected TB and extrapulmonary TB with higher HIV seropositivity rates than those with sputum-positive TB. Haitians show a similar disease pattern to that of Africa. 70% of people with tuberculosis and the acquired immunodeficiency syndrome (AIDS) had extrapulmonary disease compared with 20% of the HIV-negative people with TB. Chemotherapy of TB in Africans who also have HIV infection is not certain. Clinical impressions suggest that the disease responds well to the usual therapy. However, a Central African study found that mortality 12 months after the start of the usual drug therapy was 32.5% in HIV-seropositives compared with 1.5% in HIV-seronegatives. Several countries in Africa use short-course drug therapy for smear-positive pulmonary TB. They use the usual regime for smear-negative and extrapulmonary TB. Since AIDS, there are more skin allergic reactions to the usual drug therapy. There are more severe reactions now. Thiacetazone is the drug which probably causes this reaction. BCG immunization is used to control TB in Africa. World Health Organization guidelines are to withhold BCG from HIV- seropositive people with symptoms. What about infants born to HIV- seropositive mothers?
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PMID:Tuberculosis and human immunodeficiency virus infection in developing countries. 197 Jan 1

To determine the impact that co-infection with HIV has on the radiographic presentation of pulmonary tuberculosis, we examined the chest roentgenograms obtained before treatment in 225 HIV-tested adult Haitians with bacillary (smear or culture or both) positive pulmonary tuberculosis. There were 67 HIV-seropositive and 158 HIV-seronegative patients. Intrathoracic adenopathy alone was more common and parenchymal infiltrates less common in HIV-seropositive patients (p less than 0.05). Although a parenchymal infiltrate was less likely to be cavitating in the HIV-seropositive group (p less than 0.05) when cavitary parenchymal disease was present, HIV seropositivity did not affect the number of cavities (single or multiple) or the size of the largest cavity. Patients with AIDS were significantly more likely to have a chest radiographic pattern consistent with primary tuberculosis (80 percent) than HIV-seropositive patients without AIDS (30 percent), and the latter were significantly more likely to have such a pattern than HIV-seronegative patients (11 percent) (p less than 0.05). The HIV-seropositive patients were equally infectious, regardless of the pattern of disease (primary vs postprimary). Even though pulmonary tuberculosis in an HIV-seropositive adult probably results from reactivation of dormant foci or reinfection, the pattern on the chest roentgenogram often suggests primary disease, especially if the patient has AIDS.
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PMID:The chest roentgenogram in pulmonary tuberculosis patients seropositive for human immunodeficiency virus type 1. 198 41

To determine the risk of active tuberculosis associated with HIV infection, we retrospectively studied a cohort of HIV-seropositive and HIV-seronegative women participating in an HIV perinatal transmission study in Kinshasa, Zaire. After a median follow-up of 32 months, new cases of proven pulmonary or clinically diagnosed tuberculosis occurred in 19 of the 249 HIV-seropositive women (7.6%, 3.1 cases per 100 person-years) compared with 1 of the 310 HIV-seronegative women (0.3%, 0.12 cases per 100 person-years), for a relative risk of 26 (95% confidence interval, 5 to 125). Proven pulmonary tuberculosis was diagnosed in 7 HIV-seropositive women (2.8%, 1.2 cases per 100 person-years) and 1 HIV-seronegative woman (0.3%, 0.12 cases per 100 person-years), for a relative risk of 10 (95% confidence interval, 1.5 to 47). We estimated that 66 cases of proven pulmonary tuberculosis in 100,000 person-years of follow-up in women of childbearing age could be attributed to HIV; this is 35% of their estimated total incidence of proven pulmonary tuberculosis. Among those followed for 2 yr, 27 (11%) of 243 HIV-seropositive women died during 2 yr of follow-up compared with none of 296 HIV-seronegative women (p less than 0.001). In HIV-seropositive women with proven or clinically diagnosed tuberculosis mortality was even higher: 5 (26%) of the 19 HIV-seropositive women with proven pulmonary or clinically diagnosed tuberculosis died during follow-up compared with 22 (10%) of the 224 HIV-seropositive women not diagnosed as having tuberculosis (relative risk 2.7; 95% confidence interval, 1.1 to 6.3).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A retrospective cohort study of the risk of tuberculosis among women of childbearing age with HIV infection in Zaire. 195 54

We report 16 cases of pulmonary tuberculosis with normal chest x-ray film associated with infection by the human immunodeficiency virus (HIV). These patients belong to a sample of 125 cases of tuberculosis and HIV infection observed during the same study period. The clinical features and the diagnostic methods are described. The unusual character of the finding and its relevance are discussed, as the presentation of pulmonary tuberculosis with normal chest x-ray film was relatively common in patients with HIV infection (12.8%) in our series. This possibility should be considered in the whole population of patients with HIV infection.
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PMID:[Pulmonary tuberculosis with normal chest radiography and infection by human immunodeficiency virus]. 202 55


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