Association between clinical parameter, laboratorium and radiology along with validation of scoring system with lung tuberculosis status in adult HIV patients

Abstract

Background: Many obstacles are commonly found in diagnosing tuberculosis in HIV patients, increasing the risk of morbidity and mortality in patients. This study aimed to assess the association of several clinical, laboratory and radiological parameters to pulmonary TB status in adult HIV patients.Method: This was an observational analytic study with cross-sectional design conducted in Bali from January to June 2021, involved patients with HIV. Bivariate analysis was performed with chi-square, while multivariate analysis with multiple logistic regression. The adjusted odds ratio indicates the association of each parameter with pulmonary TB status and used as the base to compile a score for adult TB.Results : From 105 subjects, 92 subjects met the research requirements. The results of the multivariate analysis obtained several significant variables (p < 0.05); cough (OR: 17.0), shortness of breath (OR: 21.0), fever (OR: 20,0), weight loss (OR: 5.5), night sweats (OR: 31.6), chest radiograph (OR: 80.0), geneXpert (OR: 27.8), neutrophils (OR: 6.2), NLR (OR: 10.7), MLR (OR: 11.3) and ESR (OR: 11.9). The results of pulmonary TB scoring in adult HIV patients with a value of > 55 indicate pulmonary TB and < 55 non-pulmonary TB with a significant validity test result (p-value < 0.001).Conclusion: Clinical, laboratory and radiological parameters have a significant relationship with TB status in adult HIV patients and can be used as complements to the gold standard if the results of the XpertMtb examination are doubtful or not in accordance with the patient's clinical course.

Relationship Between Clinical, Laboratory, and Radiological Symptoms with The Incidence of Active Pulmonary Tuberculosis in People with Type 2 Diabetes Mellitus

“…The results of this study differ from research byYustin et al, (2021) which obtained a cut off MLR of 0.35 with a sensitivity of 90.91% and specificity of 39.58%[42]. The differences seen in these two studies were due to differences in research subjects, Yustin compared MLR in HIV-TB subjects while this study compared MLR in DM-TB subjects.…”