PURPOSE: The Philippines is 9th among 22 high tuberculosis burden countries. The prevalence of HIV in the Philippines is <1%. There is limited data on TB/HIV co-infection in the Philippines. This study aims to determine the prevalence of HIV-TB co-infection among current HIV+ patients seen at the Philippine General Hospital (PGH). This study also describes the course of this co-infection.
METHODS: Records of current patients of the STD/AIDS Guidance, Intervention, Prevention Unit (SAGIP) of the PGH were reviewed. HIV+ patients who were diagnosed to have tuberculosis by either imaging study, biopsy of tissue specimen, or AFB smear and TB culture studies were included in this study. Data and details of HIV-TB co-infection were extracted from the records.
RESULTS: We identified 9/28 (32%) current HIV+ patients to have simultaneous active tuberculosis. 33% are relapse cases. Mean time to develop active TB from HIV diagnosis is 11 months. Pulmonary involvement (88%) was the most common form of tuberculosis. Cough is the most common symptom (75%). 50% of patients had normal PE findings. The presence of reticular infiltrates (50%) was the most common radiologic finding. Lesions were mostly on the lower lung fields (62.5%). All AFB/culture positive patients had significant radiologic chest findings. The rate of sputum AFB positivity is 37.5%. One had cultures resistant to isoniazid. One case of Non-tuberculosis mycobacterium was present. There was no significant adverse effect from simultaneous treatment of TB and HIV.
CONCLUSION: The prevalence of TB HIV co-infection among current patients at the SAGIP Unit PGH is 32%. Pulmonary involvement is the most common TB presentation among our HIV patients. Cough is the most common symptom. Presence of reticular infiltrates and basal involvement are the most common radiologic findings. Sputum positivity is similar to the immunocompetent individual. There are no adverse effects from simultaneous TB and HIV treatment.
CLINICAL IMPLICATIONS: In a high TB burden country like the Philippines, clinical findings should be complemented with microbiologic and radiologic findings to diagnose and treat active TB co-infection with HIV.
DISCLOSURE: Albert Albay, No Financial Disclosure Information; No Product/Research Disclosure Information