Who is coughing in the infectious diseases unit?

NATALIA LAUFER; VANINA PETRELE; LORENA ABUSAMRA; MARÍA INÉS FIGUEROA; CLAUDIA GALLOSO; MERCEDES CABRINI; VALERIA FINK; SILVIA FONIO; ROMINA HANSEN; PATRICIA MALDONADO; ALICIA SISTO; GRACIELA BEN; HÉCTOR PÉREZ; PEDRO CAHN

Toronto, Canadá

Conferencia; AIDS 2006 - XVI International AIDS Conference; 2006

Introduction: In a hospital with high incidence of Tuberculosis (TB) with 500 unscheduled visits every month to the infectious diseases unit, a prospective study to collected information of clinical and epidemiological characteristics of TB and other respiratory diseases in HIV patients was performed. Methods: In a single clinic, with 2400 HIV-infected patients on treatment of 18000 on follow up; all patients with an unscheduled visit during 12 month were asked if they had cough, if so to sign an informed consent, to fill a questionnaire regarding their symptoms. Clinical records were reviewed. Methods: In a single clinic, with 2400 HIV-infected patients on treatment of 18000 on follow up; all patients with an unscheduled visit during 12 month were asked if they had cough, if so to sign an informed consent, to fill a questionnaire regarding their symptoms. Clinical records were reviewed. Results: During 12 months 6400 unscheduled visit were recorded, 212 with pulmonary symptoms. Diagnoses: 30 (15%) TB, 181 non-TB (18% PCP, 36% bacterial neumonia, 5% acute bronchitis, 3% sinusitis, 20% upper respiratory tract infections, 10% no diagnosis, 10% other infections). TB patients: median age 31 (21-50), 66% HIV positive. Non-TB patients: median age 35 (22-66), 92% HIV +. The signs and symptoms in TB and non TB patients were: weight loss 62% vs 31% (p 0.02), hemoptysis 28% vs 13% (p 0.07), adenomegalies 24% vs 23% (p 0.24), nights sweats 52% vs 76% (p 0.13), fever 76% vs 85.7% (p 0.48), pulmonary crackles 24% vs 21% (p 0.8), hepatomegaly 19% vs 6% (p 0.02), splenomegaly 4% vs 0% (p 0.02). Duration of symptoms was < 15 days in 43% vs 62.3% (p 0.10). TB Diagnosis: positive smear 46%, delay 1.5 day (1-18 d); positive culture 43%, 14 days (7-42 d); 6% empiric treatment. Delay to initiate TB treatment: 7 days (1-45 d). Conclusions: During this period, the diagnosis and initiation of TB treatment was made with minimal delay. Weigh loss, hepatomegaly and splenomegaly were statistically associated with TB. These findings outweigh the fact that TB must be considered in HIV patients with pulmonary complaints in developing countries regardless of their clinical presentation.