HIV-TBImpact of HIV Infection on Latent TB Among Patients With HIV-TB Co-infection

Date de début de l'étude : 1 juillet 2008

Inclusion Criteria: HIV infected +LTBI group: * Patient of either sex between 18-65 years of age * All the patients should be HIV ELISA test positive irrespective of CD4 count and presence of other opportunistic infections Antiretroviral drug naive HIV patients * No past history of TB * Patients should be either tuberculin test positive (\> 5mm) or interferon gamma release assay positive * Written informed consent to participate in the study given by participants or legal guardian * Patients able to comply with instructions and come back for a regular follow up HIV infected + Clinical TB group: * Patient of either sex between 18-65 years of age * All the patients should be HIV ELISA test positive irrespective of CD4 count and presence of other opportunistic infections * In PTB group, patient should be two sputum smear positive out of three consecutive samples * In EPTB group, diagnosis of TB will be: * Definitive -Culture confirmed * Probable -Histopathological or radiological -Clinical features and response to anti TB treatment (ATT) * Possible TB -Clinical feature and response to anti TB treatment (ATT) * Written informed consent to participate in the study given by participants or legal guardian * Patients able to comply with instructions and come back for a regular follow up HIV negative Clinical TB group: * Patients of either sex between 18-65 years of age who are permanent resident of Delhi * All patients should be HIV ELISA negative * In PTB group, patients should be two sputum smear positive (at least 1+) out of three consecutive samples * In EPTB group, diagnosis of TB will be: * Definitive -Culture-confirmed * Probable -Histopathological or radiological -Clinical features and response to anti-TB treatment (ATT) * Possible TB -Clinical features and response to anti-TB treatment (ATT) * Written informed consent to participate in the study given by participants or legal guardian * Patients able to comply with instructions and come back for a regular follow up Normal controls: * Persons of either sex between 18-65 years of age who are permanent resident of Delhi * Written informed consent to participate in the study given by participants or legal guardian * Person should not have past history of TB * Mantoux test negative (\< 10mm) * Chest-X-ray normal * Hemogram normal * Renal and liver functions normal * Hepatitis viral markers normal * No clinical evidence of malnutrition * HIV ELISA negative Exclusion Criteria: HIV infected +LTBI group: * Pregnant and lactating females * Patients who are getting steroid therapy * Transplant patients, diabetes mellitus or malignancy, chronic renal failure or liver diseases * Currently receiving cytotoxic therapy, or have received it within the last 3 months * Terminally ill as per treating clinician's judgment * Patient from outside Delhi and migrants HIV infected + Clinical TB group: * Category II and multidrug-resistant pulmonary tuberculosis * Pregnant and lactating females * Patients who are getting steroid therapy * Transplant patients, diabetes mellitus or malignancy, chronic renal failure or liver diseases * Currently receiving cytotoxic therapy, or have received it within the last 3 months * Terminally ill patient as per treating clinician's judgment * Patients from outside Delhi and migrants HIV negative Clinical TB group: * Category II and multi drug-resistant pulmonary tuberculosis * Patients who are getting steroid therapy * Transplant patients, diabetes mellitus or malignancy, chronic renal failure or liver disease * Currently receiving cytotoxic therapy, or have received it within the last 3 months * Terminally ill patient as per treating clinician's judgment * Patients unwilling to comply with the study procedures or those with history of alcohol or drug abuse Normal controls: * Transplant patients, diabetes mellitus or malignancy * Patients unwilling to comply with the study procedures or those with history of alcohol or drug abuse