Prevalence of Extrapulmonary Tuberculosis in Newly Registered HIV Patients

Abstract

Introduction: Human Immunodeficiency Virus infection and Tuberculosis are among the ten leading causes of death worldwide. In advanced AIDS, M. tuberculosis frequently causes disseminated Extra-Pulmonary Tuberculosis (EPTB). EPTB being paucibacillary infection poses a diagnostic challenge. The emergence of Cartridge Based Nucleic Acid Amplification Test (CBNAAT) has marked an important development in the field of rapid molecular diagnostics of tuberculosis. Aims and Objective: The purpose of this study was to determine the prevalence of EPTB in newly registered HIV patients visiting ART clinic and to find the prevalence of Rifampicin resistance using CBNAAT. Materials and Method: 213 newly registered HIV patients were included in the study recruited over 10 months time period and followed up for six months from recruitment. Case record of each patient with detailed history, clinical examination and necessary blood, radiological and specimen sampling done to investigate for tuberculosis was maintained. The data obtained were analyzed using SPSS 20.0 software. Result: The prevalence of EPTB in newly registered HIV patients was found to be 14.5%, with abdomen being the most common site for EPTB. Rifampicin resistance was seen in 3.2% cases. Conclusion: The result of this study showed that the prevalence of EPTB was higher compared to PTB in HIV patients. CBNAAT sensitivity for different samples were variable. This study showed maximum sensitivity of CBNAAT for lymph node aspirate (100%) and minimum for CSF (0%). Overall the sensitivity of CBNAAT was low, yet it is a very useful investigation for detection of EPTB with high positive predictive value.