Pleural tuberculosis in patients infected with HIV in Addis Ababa.
OBJECTIVE
To determine the prevalence of HIV-1 infection in patients with pleural tuberculosis and compare the clinical and radiological characteristics, effects and side effects of drugs, compliance to treatment and outcome by HIV status.


METHODS
A hospital based, prospective study.


METHODS
90 adult patients with pleural tuberculosis. 120 surgical patients admitted for non-HIV related conditions served as controls.


METHODS
Black Lion Hospital, a tertiary care referral hospital in Addis Ababa, Ethiopia.


RESULTS
22% of the patients with pleural tuberculosis versus 6.7% for the controls (p < 0.01) were seropositive for HIV-1. Amongst patients with pleural tuberculosis, HIV seropositive patients were more likely to be male, and had longer duration of illness prior to coming to hospital (p < 0.05). They had more disseminated disease (p < 0.01), bilateral pleural effusion (p < 0.05), adverse reaction to anti-tuberculosis drugs (p < 0.05) and increased mortality (p < 0.05). Hepatitis was the most common side effect observed. There was no difference in size of the effusion, clinical improvement, radiographic resolution or defaulter rate.


CONCLUSIONS
HIV associated pleural tuberculosis commonly occurs with other forms of extra pulmonary tuberculosis and responds well to treatment. Hepatitis is a frequent side effect and entails poor prognosis. We therefore recommend careful documentation of a previous history of liver disease and baseline investigation of liver function tests before initiation of treatment. The finding of bilateral pleural effusion may indicate the presence of underlying HIV infection.
Aderaye
A G
AG
Department of Internal Medicine, Faculty of Medicine, Addis Ababa University, Ethiopia.
Melaku
B K
BK
Zenebe
C G
CG
D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D000328:Adult; D005002:Ethiopia; D005260:Female; D015528:HIV Seroprevalence; D015497:HIV-1; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D016896:Treatment Outcome; D014396:Tuberculosis, Pleural / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D014504:Urban Health