TAILIEUCHUNG - CORRELATION OF SPUTUM SMEAR STATUS WITH CD4 COUNT IN CASES OF PULMONARY TUBERCULOSIS AND HIV CO-INFECTED PATIENTS-A HOSPITAL BASED STUDY IN A RURAL AREA OF CENTRAL INDIA

The Bangalore district tuberculosis programme (the programme assessed). The Bangalore District has an area of 7798 square kilometers and had a population of about million according to the census of 1961 (excluding the metropolitan area). The District has 13 towns and 2477 villages. The DTP was implemented in 1963, not by the staff of the DTC (as happens in other districts) but by trainees of two courses held in 1963 at the National Tuberculosis Institute (NTI) Bangalore. In all, 15 microscopy centres were organised in general health institutions of the District. Since, at that time, a mobile X-ray unit was also made to visit 6 centres, these centres were excluded from the study. Of. | Original Article CORRELATION OF SPUTUM SMEAR STATUS WITH CD4 COUNT IN CASES OF PULMONARY TUBERCULOSIS AND HIV CO-INFECTED PATIENTS - A HOSPITAL BASED STUDY IN A RURAL AREA OF CENTRAL INDIA Sameer Singhal1 s. N. Mahajan2 s. K. Diwan3 Abhay Gaidhane4 and z. s. Quazi4 Received on . Accepted after revision on Summary Background hl HIV-infected patients PTB Pulmonary Tuberculosis is still the commonest form of TB. The most cost-effective method of detecting TB cases among PTB suspects in high-prevalence countries is by sputum smear microscopy. World Health Organisation WHO states that sputum positivity decreases accompanying with atypical chest x-ray findings as CD4 count decreases. This expectation that infection with HIV would reduce the sensitivity of acid-fast smears due to a decreased frequency of cavitary pulmonary MTB has not been substantiated in a few studies done in the past. This study was undertaken to see the correlation of sputum smear status with CD4 count in cases of Pulmonary Tuberculosis HIV coinfected patients in our institute being a tertiary referral centre. Methodology . In our hospital based cross-sectional study 98 patients having PTB-HIV co-infection were followed and acid fast smear positivity status was assessed in correlation with chest radiograph and CD4 count. Results . Acid-fast smear positivity to negativity was almost 1 1 in CD4 count between 0-200 whereas it was 3 1 in cases of CD4 count above 200. There was significant difference p value in two groups with CD4 count cut-off value 200 which endorses the fact by WHO that sputum smear negativity increases with increase in degree of immunosupression. Conclusion . Sputum examination remains an important diagnostic tool for pulmonary tuberculosis in immunocompromised host with CD4 count above 200 but there is an urgent need for better diagnostic methods in CD4 count below 200. Indian J Tuberc 2011 58 108-112 Key words . PTB-HIV Co-infection WHO CD4 count .

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