Screening for Tuberculosis in Patients Living with HIV Under Our Clinic’s Care
Orçun Barkay1, Serpil Erol2, Seniha Şenbayrak2, Asuman Inan2, Nurgül Ceran31Department of Infectious Diseases and Clinical Microbiology, Erzincan Binali Yıldırım University Faculty of Medicine, Erzincan, Türkiye2Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Türkiye, Haydarpaşa Numune Training and Research Hospital, Istanbul, Türkiye
3Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Türkiye, Ümraniye Training and Research Hospital, Istanbul, Türkiye
INTRODUCTION: Tuberculosis (TB) is a prevalent opportunistic infection among individuals afflicted with human immunodeficiency virus (HIV). HIV infection significantly heightens the risk of TB development, whereas TB, in turn, accelerates the progression of HIV. Among individuals living with HIV, TB remains the most frequently observed disease. Our study’s aim is the evaluation of TB tests among HIV/ acquired immunodeficiency syndrome (AIDS) cases.
METHODS: This study encompassed HIV/AIDS patients aged over 18 years. Tuberculin skin test (TST) and interferon-gamma release assay test (IGRA) results of the patients were evaluated retrospectively. Microsoft Excel and Chi-square test were used to analyze the data and the relationship between assessments.
RESULTS: 109 patients underwent TST, with twenty of them displaying reactions of ≥5 mm. Ten patients received IGRA testing and two of them tested positive. Two patients who were confirmed to have active TB during the study exhibited negative TST results, with IGRA not being evaluated in these cases. Among the 22 patients found to be TST positive, TB prophylaxis was initiated. The mean CD4+ T lymphocyte count in patients with TST positivity was 500.4/mm3, whereas in patients with IGRA positivity, it was 497/mm3. Moreover, the mean CD4 + T lymphocyte count in patients with negative TST results was 444.1/mm3, and it was 392.2/mm3 in patients with negative IGRA results. No statistically significant correlation was observed between TST results and patients’ CD4 + T lymphocyte counts and serum HIV-RNA levels.
DISCUSSION AND CONCLUSION: The evaluation of TST and IGRA data within the context of HIV-infected cases presents a crucial perspective on the management of TB in this population. Our findings, alongside relevant literature, contribute to a deeper understanding of TB diagnostics and co-infection dynamics among individuals living with HIV. TB remains the leading cause of HIV-related morbidity and mortality. Screening for TB is essential in newly diagnosed HIV-infected cases.
Manuscript Language: English