بررسی میزان بروز سل بالینی در بیماران HIV مثبت شناسایی شده استان کرمانشاه از سال 1376 لغایت 1379

Background and purpose: Ïn some Çountries clinical tuberculosis is one of the first and most common manifested diseases in HÏV patients. The risk of clinical tuberculosis in HÏV patients with PPD positive is about 50% in their life period compared with 5% to 10% of HÏV negative patients. Ït is less probable to observe tubercle bacilli (TB) in sputum of TB patients with confirmed HÏV, than the other TB patients. Hence diagnosis of tuberculosis is more difficult in such patients. Ôn the other hand, because of the same clinical presentation observed in HÏV and TB, these patients would be treated as smear negative pulmonary TB and the result is over diagnosis and over treatment. The aim of this research is to study the clinical tuberculosis in HÏV patients, because by proper diagnosis, effective treatment of TB and prophylaxis in TB patients the rate of mortality in the risk group would decline. Materials and methods: The data for this study was collected from the TB patients whose HÏV Âb before infection with TB was confirmed by Ëliza Ï, ÏÏ and western blot test. Ïndication for the presence of TB was observation of tubercle bacilli in sputum,chest X-ray or other complementary actions by consultant medical practitioners. Results: Total number of 638 (8 women and 630 men) HÏV positive patients in age group of 35-39 years were identified. 73 (11.4%) pateints were identified as TB positive. Âll of them were men with mean age of 34 years and 67 (91.8%) cases with pulmonary TB, of which 59 (80.9%) cases with smear positive, 8 (10.9%) with smear negative, and 6(8.2%) with extra pulmonary. 61 patients were recently diagnosed for TB and the other cases with the history of recurrent TB (presence of TB prior to HÏV infection). Ïn 11(15.1%) of the cases, there was failure of treatment, out of which 8(10.9%) cases were expired and three cases were smear positive after completion of treatment. Four (5%) patients did not complete the treatment. Çonsidering the results, P<0.5 was significant. Çonclusion: This study indicates the importance of noticing TB in HÏV positive patients and the prevention through prophylaxis and diagnosis of all kinds of smear negative and extra pulmonary cases. Further studies are recommended on the effect of different current methods of TB treatment and on the routine duration of treatment of HÏV positive patients in different phases of the disease.