Perfil clínico-epidemiológico de pacientes com tuberculose com e sem infecção por HIV de centros de referência em Fortaleza

Abstract

Tuberculosis (TB) has for centuries challenging public policy worldwide. Disease of ancient occurrence nas been reinvigorated with the onset of acquired immunodeficiency syndrome (AIDS) in the early 80's, occupying the position of second most common opportunistic disease in AIDS patients and those with transferable characteristic of increased morbidity and mortality. The purpose of this research was to better understand the characteristics of the manifestation of TB and treatment response in patients with HIV treated in hospitais of Reference of Ceará State. For that reason a cohort study was performed for patients with TB and compared the symptoms and complications of treatment among those with co-infection HIV / TB and without HIV (HIV-/TB), from July 2007 to May 2009 , in the hospitais São José (HSJ) and Hospital Universitário Walter Cantídio (HUWC). We included 106 patients with HIV / TB and 53 patients HIV-/TB. Data were collected during hospitalization and outpatient follow-up through completion of forms and the data analyzed by the program EPI.INFO 6.0. Predominated in both groups, men (HIV + / TB: 70.8% and HIV-/TB: 62.3%) and aged 26 to 35 years (HIV + / TB: 41.5% and HIV-/TB: 35.8%). Over 85% of patients in both groups had family income less than two minimum month salaries. Group patients HIV + / TB showed a statistically significant difference (p <0.05) for the location of nodes extrapulmonary TB (14.2% versus 1.9%) for daily fever (87.6% versus 72.5%), anorexia (90.5% versus 74.0%), dry cough (47.5% versus 25.7%) and negative tuberculin test reactor (68.9% versus 28.12%). Hemoglobin <10g / 1 (56% versus 21.1%), leukocytes <4500 cél/mm3 (35.5% versus 15.8%), platelets <150,000 cél/mm3 (30.4% versus 2%) and albumin <3.0 g / dl (46% versus 17.4%) showed a statistically significant difference between groups HIV + and HIV-, respectively. HIV-/TB patients had more episodes of hemoptysis (41.7% versus 12.3%) and greater duration of symptoms prior to treatment (average of 101.98 days versus 71.44 days). The groups were similar in frequency of adverse effects to treatment for TB, but when analyzed the types of effects, HIV-/TB patients had significantly (p = 0.04) more complaints of gastrointestinal intolerance (26.4% versus 13, 2%) of peripheral neuropathy (3.8% versus 0%) and dizziness (3.8% versus 0%). The group HIV + / TB had higher incidence of hospitalization (63% versus 35.8%). The groups were similar in the form of TB diagnosis and outcome of cases. Among the patients HIV + / TB, 80% had CD4 + lymphocyte count of less than <350 cél/mm3. Symptoms related to tuberculosis had evidence.