ABDOMINAL TUBERCULOSIS IN PATIENTS INFECTED WITH THE HUMAN-IMMUNODEFICIENCY-VIRUS

We compared the presentation of abdominal tuberculosis in 43 patients infected with the human immunodeficiency virus (HIV) and in 35 patient s without HIV infection. Fever, weight loss, and extraabdominal lympha denopathy were more common in HIV-infected patients, whereas ascites a nd jaundice were more frequent in patients without HIV infection. Intr aabdominal lymphadenopathy and visceral lesions, visualized on compute d tomography scans, were more common in HIV-infected patients, whereas ascites and omental thickening were more frequent in patients without HIV infection. Aspirates of abdominal lymph nodes were the only sampl es revealing acid-fast bacilli in eight HIV-infected patients, yieldin g a rapid diagnosis. Disseminated tuberculosis was present in 93% of t he HIV-infected patients, compared with 31% of those without HIV infec tion; tuberculosis contributed to death in 23% of HIV-infected patient s and in 31% of those without HIV infection. We conclude that abdomina l tuberculosis in HIV-infected patients is almost invariably a manifes tation of disseminated disease and results in significant mortality.