DOI: 10.36347/sjams.2016.v04i03.046

Pages: 855-864

Fight against human immunodeficiency virus (HIV) is incomplete without addressing the problems associated with difficult diagnosis of tuberculosis in HIV-Tuberculosis co infected patients. Chest X-ray and Tuberculin test are primary tools to evaluate tuberculosis in HIV. The aim is to study the mode of radiological presentation of Pulmonary Tuberculosis with varying CD4 count, to study the response to PPD in Tuberculosis patients with HIV at different levels of immune suppression and to assess the reliability of the test CD4 in the suspicion of Tuberculosis in HIV patients. This prospective observational was conducted on 100 patients suffering with HIV and all the patients were subjected to necessary investigations to diagnose HIV and TB co-infection Sputum for AFB, Chest X-ray, Tridot test and the level of immune status like Tuberculin test, CD4 Count, and other if necessary. The results were recorded and analyzed. In our study majority of patients with count <200 cells /cumm were associated with atypical radiological pattern and the patients with CD4 >200 cells/cumm were associated with typical radiological pattern. Furthermore, the reliability of Tuberculin testing in the management of Tuberculosis is debatable. However it cannot be excluded as a diagnostic parameter because in the few cases that a positive tuberculin test is seen, the positive test may help to clinch the diagnosis. In patients with CD4 lower than 200, non cavitory infiltration and consolidation predominated. Involvement of lungs was atypical; diffuse or mid and lower zone involvement than classical upper lobe involvement. A high index of suspicion is necessary for the accurate and timely diagnosis of tuberculosis in HIV positive patients.