CORRELATION BETWEEN CLINICAL MANIFESTATIONS AND CD4 COUNT LEVEL IN SERO-POSITIVE HIV PATIENTS WITH TUBERCULOSIS.

Aims & Objectives: 1.To study the various clinical manifestations of both pulmonary and extrapulmonary tuberculosis in HIV positive patients. 2.To observe the impact of CD4 count on the severity of manifestations of TB in HIV positive patients. 3.To determine the correlation between clinical manifestations and CD4 count level in seropositive HIV patients with tuberculosis. Materials And Methods: Study was conducted on 100 HIV sero-positive patients with TB ( Pulmonary and Extra pulmonary) Inclusion Criteria: ? Patients who were HIV sero-positive according to NACO guidelines. ? Patients diagnosed as new TB (Pulmonary and Extrapulmonary as per WHO criteria) Exclusion Criteria: ? Patients with past H/O TB or diagnosed TB before being detected as HIV positive. ? Patients on long term immunosuppressive therapy or having co-existing immune-suppressive conditions. Results: ? Mean CD4 count in the study was relatively higher at 289.96?177.49. ? Extra pulmonary TB was the most common type. Amongst the extrapulmonary TB, TB lymphadenitis was the most common in 40% followed by Pleural effusion in 20%. ? Amongst X-ray findings, Pleural effusion was most common followed by infiltrative lesions, mediastinal and hilar lymphadenopathy. ? Sputum positivity was relatively low. Conclusions: ? Correlating CD4 levels with the various forms of TB and radiological manifestations of PTB, proves beyond doubt that sputum+ve PTB occurs at a much higher CD4 count followed by sputum-vePTB, EPTB, disseminated TB with gradually diminishing CD4 count. ? Thus overall the significant correlation of CD4 count with clinical and radiological manifestations revealed in this study re-establishes CD4 count assay as a useful diagnostic tool, prognostic indicator and a guide to assessment of response to therapy.