AEGiS-14IAC: Clinical and laboratory characteristics of tuberculosis associated with AIDS in the HAART era in Rio de Janeiro.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Clinical and laboratory characteristics of tuberculosis associated with AIDS in the HAART era in Rio de Janeiro.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10245)

Sant'Anna FM, Vieira A, Lourenco MC, Carvalho SS, Donnel M, Morgado M, Rolla V
Centro de Pesquisa Hospital Evandro Chagas/FIOCRUZ, Rio de Janeiro, Brazil

INTRODUCTION: Tuberculosis (TB) is the most important opportunistic infection associated with HIV in our country.

METHODS: All patients diagnosed with TB and AIDS from 07/ 2000 to 09/2001 in CPqHEC - FIOCRUZ were prospectivelly evaluated, in order to describe clinical and laboratory characteristics of TB in HIV+ patients and the efficacy of highly active antiretroviral treatment (HAART) in clinical practice. Our analysis was performed with SPSS for windows 8.0 package.

RESULTS: We included 38 patients 63% males (only 37% homosexuals/bisexuals) and 37% females. A positive tuberculin skin test was reactive in 81% of tested patients (n=14). CD4 counts closer to TB diagnosis was lower 200 cel mm3 in 11/34 tested patients. TB diagnosis was confirmed in 23 patients (60.5%) by visualization of acid-fast bacili in 15 cases, by positive cultures in 13 cases and in 4 cases by histopathological findings. Pulmonary TB was diagnosed in 14 (36.8%) individuals, extra pulmonary in 14 (36.8%) and disseminated in 10 (26.3%). Six out of 19 blood cultures (15.8%) were positives. Thirty-five patients received standard 6 month therapy with rifampin (R), isoniazid (H) and pyrazinamide (Z) and in 3 patients ethambutol (E) was added to TB treatment. Although a rifampin-isoniazide resistance was detected in vitro in 2 cases, all adherent patients responded to both regimens. From the 38 patients followed, 21 were naïve for antiretroviral (ARV). In 5 cases death occurred before one month of Tb treatment. HAART was prescribed in 30 individuals one month after TB treatment, in 10 cases with protease inhibitors (ritonavir-saquinavir) and in 20 cases with efavirenz. A log decrease in viral load was observed in all but 10 naïve patients with available viral load before and after HAART.

CONCLUSION: TB is a dinamic disease and in some cases very severe. In our study very few patients did not respond to HAART.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, Tuberculosis, Acquired Immunodeficiency Syndrome, Tuberculosis, Pulmonary, HIV Infections, Viral Load, Rifampin, Human, Female, Male, In Vitro

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B10245