[Clinical diagnosis and treatment of acquired immunodeficiency syndrome complicated by tuberculosis].

OBJECTIVE

To explore the clinical characteristics and method of therapy of acquired immunodeficiency syndrome (AIDS) patients complicated by tuberculosis.

METHOD: 10 cases suffered from AIDS complicated by tuberculosis from 1995 to 2000 were analyzed.

RESULTS

(1) Clinical type: of the 10 cases, hematogenous disseminated tuberculosis with cerebral tuberculosis in 3, tuberculous lymphadenitis in 4 (in which one was in mesentery, one in mediastinum and neck, 2 in neck), primary pulmonary tuberculosis in 3, with other opportunistic infections, such as Pneumocystis carinii pneumonia (PCP). (2) Immunological and tuberculin test: in all 10 cases, CD4+ cells were (2 - 87) x 10(6)/L, of them 7 cases CD4+ cells less than 50 x 10(6)/L, mean CD4+ (33 +/- 13) x 10(6)/L. Tuberculin tests were negative. (3) TREATMENT: 5 cases were treated with anti-tuberculosis and highly active anti-retrovirus treatment (HAART), the others were treated with anti-tuberculosis only. Six months later, comparing with anti-tuberculosis, CD4+ cells in patients of anti-tuberculosis with HAART increased significantly (P < 0.05, respectively).

CONCLUSIONS

The decrease of CD4+ cell might be important in AIDS with tuberculosis. Tuberculin test is not a good way of diagnosing AIDS with tuberculosis. Among AIDS complicated by tuberculosis, hematogenous disseminated tuberculosis and extra-pulmonary tuberculosis are common and usually combined with other various opportunistic infections, clinical manifestations are complex and treatment should be prolonged. This combined treatment can shorten treating time and improve the prognosis of AIDS with tuberculosis.