Tuberculosis and human immunodeficiency virus infection in west Burkina Faso: clinical presentation and clinical evolution.
OBJECTIVE
To study the relationship between human immunodeficiency virus (HIV) infection and tuberculosis (TB) in a West African country.


METHODS
A cohort study in TB patients at the TB centre of Bobo Dioulasso, Burkina Faso.


RESULTS
HIV seroprevalence rose from 12.5% in 1987 to 24.7% in 1990. Analysis of clinical findings showed that extra-pulmonary TB was not more frequent in HIV-positive patients (18.5%) than in HIV negative patients (17.3%). Four symptoms were independently associated with HIV infection: diarrhoea, lymphadenopathy, weight loss and oral candidiasis. At the end of six months of chemotherapy for TB (2SHRZ/4HR), the mortality rate among HIV-positive TB patients was 27%, versus 10% among HIV-negative TB patients (P < 0.001). There was no difference between treatment failure rates among HIV-positive patients (3.8%) and HIV-negative patients (3.9%). At the final evaluation, 18 months after the start of chemotherapy, the relapse rate was 8% in HIV-positive patients versus 5.6% in HIV-negative patients (NS). Global mortality rate during the whole study period was significantly higher in HIV-1 (40.3%) and HIV-1 + 2 (20%) patients than in HIV-2 (11.1%) and HIV-negative (12.9%) patients.


CONCLUSIONS
We conclude that, according to previous African studies, despite a higher mortality rate due generally to HIV disease itself, short-course chemotherapy of 6 months is as effective in HIV-positive patients as in HIV-negative patients, and must be continued.
Malkin
J E
JE
Université Paris XII, Service des Maladies Infectieuses, Centre Hospitalier, Villeneuve Saint Georges, France.
Prazuck
T
T
Simonnet
F
F
Yameogo
M
M
Rochereau
A
A
Ayeroue
J
J
Masson
D
D
Lafaix
C
C
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D000349:Africa / Q000453:epidemiology; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D003906:Developing Countries; D005260:Female; D015528:HIV Seroprevalence; D015497:HIV-1; D015498:HIV-2; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*