TUBERCULOUS PLEURAL EFFUSION IN HIV-SEROP OSITIVE AND SERONEGATIVE ADULT PATIENTS IN YAOUNDE (CAMEROON)

To determine the prevalence of HIV infection in adult patients with tu berculous pleural effusion in Yaounde and to investigate the impact of this infection on the clinical presentation of tuberculous pleural ef fusion, we prospectively studied, from September 1993 to August 1995, 108 consecutive patients aged 15 years and above with this disease In Unit B of the chest clinic of Hopital Jamot. Nine (8.3 %) of the patie nts were excluded from the study because of an indeterminate HIV statu s. Thirty-nine (39.4 %) of the 99 remaining patients were HIV-positive . No significant differences were found between HIV-positive and HIV-n egative patients with regard to age, sex, medical history and time sin ce onset of symptoms at admission. In contrast, dyspnoea, night sweats , diarrhoea, oral thrush, peripheral lymphadenopathy and hepatosplenom egaly were significantly more common in HIV-positive than in HIV-negat ive patients. Similarly tuberculin anergy (53.8 % vs 6.7 %, p < 10(-6) ), pulmonary infiltrates (59 % vs 33.3 %, p = 0.01) and pericardial in volvement (35.9 % vs 18.8 %, p = 0.05) were more likely to be found in HIV-positive than in HIV-negative patients. No significant difference s were observed in the results of routine biochemical and cytological analysis of pleural fluid between the two groups of patients.