Impact of human immunodeficiency virus infection on abdominal tuberculosis in western India.

ABSTRACT

PIP: Human immunodeficiency virus (HIV) infection dramatically increases the risk of progression of latent tuberculosis infection. A case-control study conducted during 1992-95 at an urban teaching hospital in Mumbai, India, investigated the seroprevalence of HIV infection in patients with pulmonary and abdominal tuberculosis. Enrolled were 387 patients with active pulmonary tuberculosis, 108 with abdominal tuberculosis, and 8359 volunteer blood donors. The HIV seroprevalence rates in these 3 groups were 6.9%, 16.6%, and 1.4%, respectively. The majority of HIV-infected abdominal tuberculosis patients were in the early clinical stages of the disease and not significantly immunosuppressed. These patients had higher rates of lymphatic and hepatic tuberculosis than seronegative patients, suggesting disease dissemination. All tuberculosis patients, regardless of HIV status, responded well to antituberculous drugs in standard doses. These findings suggest that all patients with pulmonary and abdominal tuberculosis should be screened for HIV. In addition, long-term chemoprophylaxis in HIV-infected persons from tuberculosis-endemic areas should be considered.