CLINICAL-FEATURES OF HIV-SEROPOSITIVE AND HIV SERONEGATIVE PATIENTS WITH TUBERCULOUS LYMPHADENITIS IN DAR-ES-SALAAM

Setting: The medical wards of a referral hospital in Dar es Salaam, Ta nzania. Objective: To investigate the impact of HIV infection on clini cal features in tuberculous lymphadenitis. Design: A prospective clini cal study of HIV seropositive and HIV seronegative patients with lymph adenopathy. Results: Of 128 patients with peripheral lymphadenopathy, 24 had no tuberculosis (TB) and in 10 patients TB was found only in ot her organs. The remaining 94 patients, of whom 76% were HIV seropositi ve, formed our study population. TB lymphadenitis was considered prove n in 89 and probable in 5 patients. Disseminated TB (both TB adenitis and TB in other organs) was diagnosed more often in HIV seropositive t han in HIV seronegative patients (52% versus 26%, P < 0.03). 59% of th e 71 HIV-infected patients compared to only 4% of the 23 patients with out HIV infection were over 30 years of age (P < 0.02). The following clinical features were significantly associated with HIV infection: dy spnoea, respiratory rate > 20/min, low motility score (bedridden), neu rological abnormalities, hepatomegaly, splenomegaly, lymph node size < 2.5 cm, negative PPD skin test, lymphopenia (< 1000/cm(3)) and presen ce of pleural fluid. Conclusion: Co-infection with HIV influences seve ral clinical and laboratory features in patients with tuberculous lymp hadenitis.