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Association between clinical parameter, laboratorium and radiology along with validation of scoring system with lung tuberculosis status in adult HIV patients

  • Wayan Evie Frida Yustin ,
  • I Ketut Agus Somia ,
  • Ni Luh Putu Eka Arisanti ,
  • I G N Bagus Ngurah Artana ,
  • Ida Ayu Jasminarti Dwi Kusumawardani ,
  • Ni Wayan Candrawati ,
  • Ida Bagus Ngurah Rai ,


Abstract

Background: Many obstacles are commonly found in diagnosing tuberculosis in HIV patients, increasing the risk of morbidity and mortality in patients. This study aimed to assess the association of several clinical, laboratory and radiological parameters to pulmonary TB status in adult HIV patients.

Method: This was an observational analytic study with cross-sectional design conducted in Bali from January to June 2021, involved patients with HIV. Bivariate analysis was performed with chi-square, while multivariate analysis with multiple logistic regression. The adjusted odds ratio indicates the association of each parameter with pulmonary TB status and used as the base to compile a score for adult TB.

Results : From 105 subjects, 92 subjects met the research requirements. The results of the multivariate analysis obtained several significant variables (p < 0.05); cough (OR: 17.0), shortness of breath (OR: 21.0), fever (OR: 20,0), weight loss (OR: 5.5), night sweats (OR: 31.6), chest radiograph (OR: 80.0), geneXpert (OR: 27.8), neutrophils (OR: 6.2), NLR (OR: 10.7), MLR (OR: 11.3) and ESR (OR: 11.9). The results of pulmonary TB scoring in adult HIV patients with a value of > 55 indicate pulmonary TB and < 55 non-pulmonary TB with a significant validity test result (p-value < 0.001).

Conclusion: Clinical, laboratory and radiological parameters have a significant relationship with TB status in adult HIV patients and can be used as complements to the gold standard if the results of the XpertMtb examination are doubtful or not in accordance with the patient's clinical course. 

Keywords: Clinical laboratorium radiology TB status Human immunodeficiency virus (HIV) XpertMtb

References

  1. Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar [Internet]. Jakarta; 2018.Tersediapada:http://www.depkes.go.id/resources/download/infoterkini/materi_rakorpop_2018Hasil Riskesdas 2018.pdf
  2. World Health Organization (WHO). Global Tuberculosis Report 2019. 2019.
  3. Kasper; Denis L; et al. Harrison’s Principles of Internal Medicine 19th Edition. New York: McGraw-Hill Education; 2018.
  4. Fishman JA, Grippi MA, Kotloff RM, et al. Fishman’s Pulmonary Disease and Disorders Fifth Edition. New York: Elsevier Saunder; 2016.
  5. Kemenkes RI. Pedoman Nasional Penangulangan Tuberkulosis. Jakarta: Kementerian Kesehatan RI; 2014.
  6. Martino RJ, Chirenda J, Mujuru H, et al. Characteristics Indicative of Tuberculosis/HIV Coinfection in a High-Burden Setting: Lessons from 13,802 Incident Tuberculosis Cases in Harare, Zimbabwe. Am J Trop Med Hygine. 2020;103(1):214–20.
  7. Wang GJ, Phypers M, Elis E. Demographic, laboratory and clinical characteristics of HIV-positive tuberculosis cases in Canada. J Infect Public Health. 2009;2(3):112–9.
  8. Prado TN, Rajan JV, Miranda AE, et al. Clinical and epidemiological characteristics associated with unfavorable tuberculosis treatment outcomes in TB-HIV co-infected patients in Brazil: a hierarchical polytomous analysis. Brazilian J Infect Dis. 2017;21(2):162–70.
  9. Pangaribuan L, Perwitasari D, Kristina, et al. Faktor-faktor yang memengaruhi kejadian tuberkulosis paru pada umur 15 tahun ke atas di Indonesia. Bul Penelit Sist Kesehat. 2020;23(1):10–7.
  10. Sterling TR, Pham PA, Chaisson RE. HIV Infection—Related Tuberculosis: Clinical Manifestations and Treatment. Clin Infect Dis. 2010;50(3):223–30.
  11. Mirambo MM, Hamis HK, Idd S, et al. Manifestations of Tuberculosis in TB-HIV co-infected patients: A retrospective study. Tanzania Med J. 2012;26(2):76–82.
  12. Patel AK, Thakrar SJ, Ghanchi FD. Clinical and laboratory profile of patients with TB/HIV coinfection: A case series of 50 patients. Lung India. 2011;28(2):93–6.
  13. Kementerian Kesehatan Republik Indonesia. Pedoman Pengendalian TB Paru di Indonesia. Jakarta: Kementerian Kesehatan RI; 2014.
  14. Salwani D, Nasir UJ, Yunihastuti E, et al. Kemampuan Gabungan Gejala Klinis dan Pemeriksaan Radiologis serta Biakan MGIT 960 dalam Diagnosis Tuberkulosis Paru pada Pasien HIV. J Penyakit Dalam Indones. 2018;5(2):88–93.
  15. Sharma SK, Mohan A, Sharma A. Challenges in the diagnosis & treatment of miliary tuberculosis. Indian J Med Res. 2012;135(5):703–30.
  16. Sharma SK, Mohan A, Sharma A. Miliary tuberculosis: A new look at an old foe. J Clin Tuberc Other Mycobact Dis. 2016;3:13–27.
  17. World Health Organization (WHO). Guidance for national tuberculosis programmes on the management of tuberculosis in children. Geneva: WHO Int; 2014.
  18. Lee MP, Chan JW, Ng KK, et al. Clinical manifestations of tuberculosis in HIV-infected patients. Respirology. 2000;5(4):423–6.
  19. Pane IDR. Peran Rasio Netrofil Limfosit Count dalam Memberdakan antara TB Paru dan Pneumonia Komunitas. Universitas Sumatera Utara; 2015.
  20. Kerkhoff AD, Wood R, Lowe DM, et al. Blood Neutrophil Counts in HIV-Infected Patients with Pulmonary Tuberculosis: Association with Sputum Mycobacterial Load. PLoS One. 2013;8(7):67–9.
  21. Sorsa A. The Diagnostic Performance of Chest-X-Ray and Erythrocyte Sedimentation Rate in Comparison with GeneXpert® for Tuberculosis Case Notification Among Patients Living with Human Immunodeficiency Virus in a Resource-Limited Setting: A Cross-Sectional Study. Risk Manag Heal Policy. 2020;13:1639–46.
  22. Sormin DE, Siagian P, Sinaga BYM, et al. Neutrophyl Lymphocyte Ratio pada Pasien Tuberkulosis Paru dan Tuberkulosis Resisten Obat. J Respir Indo. 2018;38(3):177–80.
  23. Yin Y, Kuai S, Liu J, et al. Pretreatment neutrophyl lymphocyte ratio in peripheral blood was associated with pulmonary tuberculosis retreatment. Arch Med Sci. 2017;13:404–11.
  24. Choudhary EK, Wall KM, Njuguna I, et al. Monocyte-to-Lymphocyte Ratio Is Associated With Tuberculosis Disease and Declines With Anti-TB Treatment in HIV-Infected Children. J Acquir Imuune Defic Syndr. 2019;80(2):174–81.
  25. Mandal SK, Chavan L. Erythrocyte Sedimentation Rate Values in Cases of Active Tuberculosis without HIV Co-Infection. J Med Sci Clin Res. 2016;4(10).

How to Cite

Yustin, W. E. F., Somia, I. K. A., Arisanti, N. L. P. E., Artana, I. G. N. B. N., Kusumawardani, I. A. J. D., Candrawati, N. W., & Rai, I. B. N. (2021). Association between clinical parameter, laboratorium and radiology along with validation of scoring system with lung tuberculosis status in adult HIV patients. Bali Medical Journal, 10(3), 1085–1092. https://doi.org/10.15562/bmj.v10i3.2787
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Wayan Evie Frida Yustin
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I Ketut Agus Somia
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Ni Luh Putu Eka Arisanti
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I G N Bagus Ngurah Artana
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Ida Ayu Jasminarti Dwi Kusumawardani
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Ni Wayan Candrawati
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Ida Bagus Ngurah Rai
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