The Indian Journal of Tuberculosis - LRS Institute of Tuberculosis ...

SUMMARIES OF PAPERS 169
Immune Reconstitution Tuberculosis in HIV
patients after Anti-retroviral Therapy
S. Rajasekaran, Satish Narayan, Vijila and N.
Ravichandran.
Background: Free Anti-retroviral therapy is being
given to eligible people living with HIV in India since
April 2004. Govt. Hospital of Thoracic Medicine,
Tambaram Sanatorium, Chennai is one of the largest
centres managing HIV/AIDS patients with Antiretroviral
therapy in India.
Objectives: This study finds out the Incidence of
Tuberculosis as the manifestation of ‘Immune
Reconstitution Syndrome’ after the initiation of
Antiretroviral therapy in patients with HIV/AIDS.
Methodology: All the patients, placed under ART,
are being followed up for the occurrence of
Tuberculosis from April 2004 to November 2005 at
GHTM, Tambaram Sanatorium, Chennai.
Results: 2,100 HIV patients were initiated Antiretroviral
Therapy till November 2005 and of whom 1,461
(69.6%) were already treated for Tuberculosis. 302
(14.4%) had Immune reconstituted diseases and 80
(3.8%) had Tuberculosis, as the component of
Immune Reconstitution Syndrome (IRS).
Conclusion: Occurrence of Tuberculosis as Immune
Reconstitution manifestation is significantly high after
antiretroviral therapy. This results in starting or
restarting anti-tuberculosis treatment with the
changed or modified antiretroviral therapy in a large
number of patients.
Manifestation of Tuberculosis in HIV patients -
A large Indian Study
S. Rajasekaran, S. Annadurai, Rabeetha, Mahesh, A.
Mahilmaran, S. Kumar and K. Raja.
Background: Govt. Hospital of Thoracic Medicine
(GHTM), Tambaram Sanatorium, Chennai, is the
largest HIV care centre in South East Asia. More
than 28,000 HIV patients visited it in a calendar year
for care and support.
Objectives: To identify the Clinical Manifestations
of Tuberculosis among HIV patients attending the
hospital for the first time and to assess the modes of
presentation of Tuberculosis.
Methodology: Database of TB-HIV Patients
Information System, especially evolved for GHTM,
was utilized. The particulars confined to HIV- TB
Co-infection among patients visited the hospital for
the first time from January to November, 2005 were
considered for the analysis.
Results: 14,487 HIV confirmed patients were
screened for the possible presence of Tuberculosis.
4,176 (28.9%) had tuberculosis. Among those who
had tuberculosis 2,703 (64.7%) had pulmonary TB
and the remaining 1,473 (35.3%) had either
disseminated or extra pulmonary TB. Sputum smear
positivity for AFB was evident in 615 patients (15%).
Conclusion: Just over one fourth of the HIV patients
were found to have manifestation of Tuberculosis
at the time of detection of HIV. Sputum smear
negative pulmonary tuberculosis and non-pulmonary
tuberculosis were found to dominate the clinical
presentation in HIV patients.
Linking of TB & HIV Programmes: Outcome
of referral system: A Tamil Nadu experience.
S. Rajasekaran, K. Murugesan, A. Mahilmaran,
O.R. Krishnarajasekhar, S. Kumar, S. Annadurai
and P.R. Khaiser Ahamed.
Background: National TB Control Programme is a
well-integrated programme producing the desired
results in the field conditions. National AIDS Control
Programme is a vertical one till now, planning for
‘mainstreaming’ in NACP Phase III. Linking both
the programmes needs enormous understanding,
efforts and innovations.
Objectives:
1. To identify the outcome of referred HIV patients
with Tuberculosis to various centres and the
percentage of them started on TB treatment, and
2. To find out the needs and mechanism to maximize
the outcome of TB referrals to DOTS centres.
Indian Journal of Tuberculosis