Tuberculosis in HIV-infected patients in the HAART era

SummaryTuberculosis in one of the most common opportunistic infections in HIV infected patients. HIV promotes progression of Mycobacterium tuberculosis latent infection to active disease and in turn M tuberculosis enhances HIV replication. During eight year period 51 cases of tuberculosis was recognized in Department of Infectious Diseases and Hepatology in Bydgoszcz. Only 4 patients were on antiretroviral therapy and of those who never received antiretroviral treatment; 70% had a CD4 count >100 cells/ml at the time of tuberculosis, and the high proportion (25.4%) of patients were diagnosed with HIV infection concurrently with tuberculosis. Diagnosis was confirmed by isolation of Mycobacterium tuberculosis and by the detection of nucleic acids of pathogen in 96.1% patients. The sputum smear was positive only in 5 cases of pulmonary tuberculosis and in three cases of disseminated tuberculosis was the most common clinical manifestation of disease in study population. A total of 8 patients with pulmonary involvement the chest radiograph examination was normal. Tuberculosis in HIV infected patients is in spite of availability of antiretroviral therapy a serious medical and epidemiological problem.