title: [Correlation of the manifestations of tuberculosis and the degree of immunosuppression in patients with HIV].
abstract: BACKGROUND
  Correlation of the manifestations of tuberculosis and the degree of immunosuppression in patients with HIV.
  
  
  BACKGROUND
  The advent of HIV has contributed to the increase in the number of people with tuberculosis. The clinical and paraclinical of TB/HIV co-infected are polymorphic and function of immune status.
  
  
  OBJECTIVE
  To determines the clinical and paraclinical characteristics of TB related to different levels of CD4 lymphocytes.
  
  
  METHODS
  A retrospective case series based on analysis of 450 patients with both TB/HIV co-infections. It focused on the records of patients with pulmonary smear-positive (TPM +) with a positive HIV status. The effect of immunosuppression was analyzed in groups based on the CD4 count (<200/mm(3), of 200-350/mm(3) and>350/mm(3)), in a chronological fashion from April to September 2010 until there were 150 patients in each CD4 group.
  
  
  RESULTS
  Among the 450 patients, 71.1% were between 25 and 45years old. The clinical signs were more significant as the level of CD4 fell. The clinical signs were predominantly fever (93%) and weight loss (62.7%). Pulmonary cavitation (59.3%), infiltrates (38.7%) and the location of the lesions at the lung apex (72%) were more common in the third group patients. By contrast, extra pulmonary lesions (mediastinal lymphadenopathy, pleurisy) and normal x-ray (9.3%) were more frequent in patients of the first group. The scarcity of cavitations (22.3% compared to 59.3% CD4>350) and the increase in associated lesions became more marked if patients were immunocompromised. Hematologic, hepatic, renal disorders were more frequent and severe in the most immunocompromised patient group.
  
  
  CONCLUSIONS
  HIV-associated tuberculosis has an atypical clinical, radiological, biological presentation and is more severe when there is significant immunosuppression.
authors.affiliation: Service de pneumologie, CHU de Cocody, Abidjan BP 22 V13, 1105 Abidjan, Côte d'Ivoire. Electronic address: kouassiboko@hotmail.fr.
authors.forename: B
authors.initials: B
authors.lastname: Kouassi
authors.forename: A
authors.initials: A
authors.lastname: N'Gom
authors.forename: K
authors.initials: K
authors.lastname: Horo
authors.forename: C
authors.initials: C
authors.lastname: Godé
authors.forename: B
authors.initials: B
authors.lastname: Ahui
authors.forename: N M L
authors.initials: NM
authors.lastname: Emvoudou
authors.forename: N
authors.initials: N
authors.lastname: Koffi
authors.forename: J C
authors.initials: JC
authors.lastname: Anon
authors.forename: K F
authors.initials: KF
authors.lastname: Konaté
authors.forename: M
authors.initials: M
authors.lastname: Itchi
authors.forename: M O
authors.initials: MO
authors.lastname: Koffi
authors.forename: A
authors.initials: A
authors.lastname: Ano
authors.forename: S F
authors.initials: SF
authors.lastname: Manewa
authors.forename: A
authors.initials: A
authors.lastname: Gro Bi
authors.forename: E
authors.initials: E
authors.lastname: Aka-Danguy
authors.forename: A
authors.initials: A
authors.lastname: Gnazé
authors.forename: K
authors.initials: K
authors.lastname: Touré
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D000328:Adult; D060085:Coinfection / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology*; D015497:HIV-1; D006801:Humans; D007108:Immune Tolerance; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D055815:Young Adult
keywords: Biologie; Biology; CD4; Clinical radiology; Clinique; Côte d’Ivoire; HIV; Radiologie; Tuberculose; Tuberculosis; VIH