Tuberculosis in HIV-infected patients in Croatia between 1986 and 2005

Puljiz, Ivan and Begovac, Josip (2006) Tuberculosis in HIV-infected patients in Croatia between 1986 and 2005. Collegium Antropologicum, 30 (Suppl.). pp. 53-58. ISSN 0350-6134

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Abstract

A retrospective medical chart review was performed on 65 HIV-infected patients with tuberculosis hospitalized between 1986 and 2006 at the University Hospital for Infectious Diseases "Dr. Fran Mihaljevic", Zagreb. Thirty two patients presented with pulmonary involvement, 13 with extrapulmonary, and 20 patients had disseminated tuberculosis. Forty five patients had an abnormal chest X-ray. Mycobacterium tuberculosis was identified in 35 (53.9%) patients. Ten (15.3%) of 65 patients had already been receiving antiviral therapy, while another 31 (47.7%) initiated antiviral therapy after antituberculosis therapy. Tuberculosis-associated immune reconstitution inflammatory syndrome was observed in 11/27 (40.7%) patients. Forty one patient received the standard six month course of antituberculous therapy, while in 12 patients the therapy was prolonged. Twenty one patient (32%) experienced an adverse event to antituberculosis drugs. Twelve patients died (18.5%). After the introduction of highly active antiviral therapy (HAART) the mortality decreased. The incidence of tuberculosis in HIV-infected patients in Croatia is increasing, and tuberculosis is still an important opportunistic infection in our HIV-infected patients.

Abstract in Croatian

Rad se temelji na retrospektivnoj analizi 65 HIV-pozitivnih bolesnika s tuberkulozom koji su bili hospitalizirani u Klinici za infektivne bolesti »Dr. Fran Mihaljević« u Zagrebu od 1986. do 2005. godine. Trideset i dva bolesnika su imala plućni oblik bolesti, 13 izvanplućni, a 20 je imalo diseminiranu tuberkulozu. Patološki nalaz na rendgenskoj slici pluća otkriven je u 45 bolesnika. Mycobaterium tuberculosis je dokazan u 53,9% bolesnika. Deset (15,3%) bolesnika je bilo na antivirusnoj terapiji prije dijagnosticiranja tuberkuloze dok je antivirusna terapija uvedena u 31 (47,7%) bolesnika nakon započinjanja liječenja tuberkulostaticima. Imunorekonstruktivni inflamatorni sindrom je zabilježen u 11/27 (40,7%) bolesnika. Standardno šesto mjesečno liječenje provedeno je u 41 bolesnika, a 12 bolesnika liječeno je dulje. Nuspojave su zabilježene u 21 bolesnika. Umrlo je 12 (18,5%) bolesnika. Nakon uvođenja visoko učinkovite antiretrovirusne terapije (HAART) smanjuje se smrtnost. Incidencija tuberkuloze u HIV-pozitivnih osoba u Hrvatskoj je u porastu, a tuberkuloza je važna oportunistička infekcija u naših HIV-pozitivnih bolesnika.

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