TUBERCULOSIS AND HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION IN WEST BURKINA-FASO - CLINICAL PRESENTATION AND CLINICAL EVOLUTION

OBJECTIVE: To study the relationship between human immunodeficiency vi rus (HIV) infection and tuberculosis (TB) in a West African country. D ESIGN: A cohort study in TB patients at the TB centre of Bobo Dioulass o, Burkina Faso. RESULTS: HIV seroprevalence rose from 12.5% in 1987 t o 24.7% in 1990. Analysis of clinical findings showed that extra-pulmo nary TB was not more frequent in HIV-positive patients (18.5%) than in HIV negative patients (17.3%). Four symptoms were independently assoc iated with HIV infection: diarrhoea, lymphadenopathy, weight loss and oral candidiasis. At the end of six months of chemotherapy for TB (2SH RZ/4HR), the mortality rate among HIV-positive TB patients was 27%, ve rsus 10% among HIV-negative TB patients (P < 0.001). There was no diff erence between treatment failure rates among HIV-positive patients (3. 8%) and HIV-negative patients (3.9%). At the final evaluation, 18 mont hs after the start of chemotherapy, the relapse rate was 8% in HIV-pos itive patients versus 5.6% in HIV-negative patients (NS). Global morta lity rate during the whole study period was significantly higher in HI V-1 (40.3%) and HIV-1 + 2 (20%) patients than in HIV-2 (11.1%) and HIV -negative (12.9%) patients. CONCLUSION: We conclude that, according to previous African studies, despite a higher mortality rate due general ly to HIV disease itself, short-course chemotherapy of 6 months is as effective in HIV-positive patients as in HIV-negative patients, and mu st be continued.