Naslov
Tuberculosis in HIV infected patients
(Tuberkuloza u pacijenata inficiranih HIV-om)

Autori
Begovac, Josip

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
Biochemia medica - Symposium lectures abstracts / - Zagreb : Medicinska naklada, 2012, A19-A19

Skup
23rd Symposium Croatian Society for Medical Biochemistry and Laboratory Medicine. Tuberculous infection – continuous challenge

Mjesto i datum
Zagreb, Hrvatska, 22.09.2012

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Nije recenziran

Ključne riječi
Tuberculosis; HIV
(Tuberkuloza; HIV)

Sažetak
Because of the high burden of disease in developed countries, Mycobacterium tuberculosis infection is the most common opportunistic disease in HIV infected patients. In Croatia, tuberculosis is the second most common opportunistic infection diagnosed in HIV infected individuals. Despite recent advances, the diagnosis of tuberculosis is still challenging and empiric antituberculosis therapy is still necessary, particularly in resource limited settings. A diagnostic algorithm including assessment of symptoms (fever, cough, and night sweats), chest radiography, sputum smear examination and CD4 cell counts determination can be used to reliable exclude the diagnosis of tuberculosis in HIV infected patients. In smear negative specimens new diagnostic tools such as Xpert MTB/RIF can improve the diagnostic yield. In the early stages of HIV-infection the clinical symptoms of tuberculosis are similar to those in HIV-negative patients. Extrapulmonary tuberculosis occurs predominantly in patients with CD4+ cells below 200/mm3, most commonly affecting the cervical lymph nodes. Other extrapulmonary manifestations include tuberculosis meningitis, miliary or disseminated tuberculosis, however, any organ system can be involved. Simultaneous antiretroviral and antituberculosis therapy is challenging because of the associated mortality of tuberculosis in severe immunodeficiency, the so called immune reconstruction syndrome and drug interactions. Treatment of tuberculosis has a priority. However, several studies found that the earlier antiretroviral treatment in patients with tuberculosis, particularly in patients with less than 50 CD4+ cells/mm3 or less than 200 CD4+ cells is associated with less mortality. Hence it is recommended to start antiretroviral therapy within two-weeks of antituberculosis therapy in patients with 50-100 CD4+ cells/mm3.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA