Evaluation of tuberculosis in hiv patients using the xpert mtb/rif assay and its rifampicin resistance pattern at tertiary care Center in North India

Evaluation of tuberculosis in hiv patients using the xpert mtb/rif assay and its rifampicin resistance pattern at tertiary care Center in North India

Author: 
Dr. Lucky Sharma, Dr. Vimal Bharti, Dr. Ashok Sharma, Dr. Balbir Singh Verma, Dr. Malay Sarkaar, Dr. Parmod Jaret and Dr. Amit Sachdeva
Abstract: 

Background: Tuberculosis (TB) is the most common opportunistic infection among people living with HIV. It is also the leading cause of death among people living with HIV. Patients with HIV-pulmonary tuberculosis co-infection are most likely benefitted by Xpert MTB/RIF Assay. Aims & objective: Evaluation of Tuberculosis in HIV patients using the Xpert MTB/RIF assay and its rifampicin resistance pattern at tertiary care center in north India. Material & methods: It was a cross sectional study conducted in a period of one year from 1st July 2015 to 30th June 2016 in the department of Medicine at Indira Gandhi Medical College and Hospital, Shimla. The study population included the HIV positive patients attending the ART clinic /Medicine OPD/Pulmonary Medicine OPD/admitted in Medicine ward. Out of these patients with HIV infection, the diagnosis of tuberculosis was established by further workup. Data collected was entered and analyzed in excel sheet, using appropriate statistical software and test of significance. Results: Among 95 patients with HIV infection, the diagnosis of tuberculosis was established in 54 patients after further workup.The mean age of patients was 40.4 yrs . Out of 54 patients, 40 were males and 14 were females. Majority of the patients were from Shimla district i.e.24 (44.4%). Fever (85%), pallor (81.5%) , cough of more than 2 weeks (55%), Oral thrush (53.7%) and weight loss of more than 10% in the past 6 months (51%) were the most common symptoms of Patients on Presentation.Pulmonary tuberculosis (PTB) was found in 26 patients and extra-pulmonary tuberculosis (EPTB) in 28 patients. Nineteen (73.1%) out of twenty-six with pulmonary tuberculosis were gene xpertpositive while Xpert MTB/RIF was positive in only five (17.85%) of the 28 patients with extrapulmonary tuberculosis. Conclusion: This study has shown that Xpert MTB/RIF has remarkably increased the sensitivity of diagnosis of pulomonary TB than extrapulmonary TB.

Paper No: 
1673