TUBERCULOSIS AND INFECTION DUE TO HIV - E VALUATION OF 132 CASES

Tuberculosis is currently one the more frequent opportunistic infectio ns in patients infected by Human Immunodeficiency Virus (HIV) in our s etting. Its extrapulmonar localization is considered as diagnostic of the Acquired Immunodeficiency Syndrome (AIDS). We have evaluated the e pidemiological, clinical, microbiological, histological and immunologi cal characteristics of 120 patients in the Asturias region who had a t uberculosis diagnosed in any localization, during the period between 1 984 and 1991, belonging to a series of 570 patients infected by HIV. P ulmonar types were comparatively analyzed to the extrapulmonar and dis seminated ones. Tuberculosis was pulmonar only in 44 occasions (PT), i n 36 it was extrapulmonar (EPT) and in 52 disseminated (DT). The more frequent risk factor for the HIV infection was the parenteral consumpt ion of drugs (78,8%). The final diagnosis was microbiologic in 81% of the cases, while bacilloscopia was positive in 62% of the cases. The h istologic study showed the presence of granulomas in 86% of the tissue s studied and necrosis in 81%. EPT and DT were related with a worse im mune situation, bigger mortality rates attributed to tuberculosis and worse survival (p 0,069). Tuberculosis in patients infected by HIV app ears mainly in CDVP, being its symptoms the normal ones, but extrapulm onar forms are clearly predominant and within this group those with a ganglionar localization. Normal diagnostic procedures yield a good res ult. EPT and DT are significantly related to a more severe immunodefic iency in comparison with PT. Survival and prognosis are better in the PT group.