Tuberculosis detection and diagnosis challenges in persons living with human immunodeficiency virus

Abstract

Background. Tuberculosis (TB) remains the leading cause of death among patients infected with the human immunodeficiency virus (HIV). The immunosuppression caused by HIV significantly contributes to the development of TB. Detection and appropriate treatment of TB in HIV-positive populations remain a major challenge. Objective(s). The study aimed to evaluate and analyze the main challenges and difficulties in the detection and diagnosis of patients with TB/HIV coinfection, as well as the treatment success rate. Materials and methods. A retrospective, selective, case-control study was conducted, including 86 patients diagnosed with pulmonary tuberculosis between January 1 and December 31, 2023. The patients were divided into two study groups: Group 1 – 38 patients with CD4 levels >200 cells/mm³; Group 2 – 48 patients with CD4 levels <200 cells/mm³. Results. In the "2nd SG" predominates among male patients with co-infection TB/HIV along with individuals belonging to the 25-34 and >55 age ranges yet "1st SG" shows higher presence among female participants in addition to people aged 45-54 years. Patients under 1st SG" had more medical conditions at higher rates than those under the other immunosuppressive regimens. The examined conditions include Pneumonia with P. jiroveci (21% vs 0%), Toxoplasmosis (13% vs 0%), Herpes zoster (16% vs 0%), Oropharyngeal Candidiasis (82% vs 40%), Thrombocytopenia (18% vs 4%). Drug-resistant TB causes higher rates of deaths among the "2nd SG" patients (42% vs 27%). Conclusion(s). In clinical settings, the diagnosis of AIDS was suggested by the presence of oropharyngeal candidiasis, toxoplasmosis, herpes zoster and P. jirovecii pneumonia. Effective management of TB/HIV co-infection requires integrated, multidisciplinary care to improve treatment outcomes and reduce mortality.