CLINICAL COURSE OF HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 ASSOCIATED PULMONARY TUBERCULOSIS DURING SHORT-COURSE ANTITUBERCULOSIS THERAPY

To describe the clinical response to antituberculosis therapy in HIV-1 disease, 49 HIV-1 positive Ugandan adults (mean age 29.4 years; 68% m en) with active pulmonary tuberculosis (PTB) were studied in a trial o f rifampicin containing short-course antituberculosisis regimens, At p resentation, 18 patients were PPD non-reactors (PPD skin test indurati on<2mm), ten patients (20%) had non-cavitary lung disease. The mean CD 4 lymphocyte count at presentation was 339/mu l (+/-SD 275), Among pat ients with abnormal baseline clinical values, the median time to resol ution of fever, weight gain of 10%, increase of haemoglobin to 10 g/dl and of Karnofsky performance score (KPS) to 80 occurred before sputum smear and culture conversion, Short-term survival was associated with : baseline lymphocytes <1200/mu l, (Odds ratio (OR) 17.5), CD4(+) lymp hocytes <200/mu l, (OR 9.8), cavitary Lung disease, (OR 0.6), atypical chest radiograph, (OR 6.7), and PFD non-reactivity, (OR 13.5), PPD no n-reactivity and non-cavitary disease were associated with significant ly lower CD4 lymphocyte counts, Affordable serial measurements paralle l the response to therapy and predict survival in HIV-associated PTB.