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2000
Volume 23, Issue 2
  • ISSN: 1570-162X
  • E-ISSN: 1873-4251

Abstract

Background

Tuberculosis (TB), caused by Mycobacterium tuberculosis, often becomes a comorbidity in individuals infected with Human Immunodeficiency Virus (HIV), the cause of Acquired Immunodeficiency Syndrome (AIDS). HIV-positive individuals have a 30-fold higher risk of contracting TB compared to non-HIV individuals. Assessment of HIV-TB disease progression commonly relies on measuring CD4 cell counts. However, in areas with limited access, the World Health Organization (WHO) recommends using Total Lymphocyte Count (TLC) ≤ 1200 cells/μL as an alternative. Additionally, chest X-rays, a widely accessible radiological method, aid in diagnosing TB in HIV-positive patients, complementing TLC in assessing disease progression in limited facilities.

Objective

The objective of this study was to analyze the differences in the location and characteristics of TB lesions based on HIV status and TLC levels.

Methods

A case-control study was conducted at Adam Malik Central Hospital on pulmonary TB patients from December 2021 to December 2022, meeting inclusion criteria. Evaluation of TB lesion locations and characteristics was performed by two researchers, while HIV status and TLC data were extracted from medical records.

Results

The study involved 154 subjects, including 77 HIV-positive and 77 non-HIV individuals. The percentage of male participants was 81.8%, with a mean age of 43.4 ± 14.4 years. The significant differences in the characteristics and locations of lesions (cavities, miliary lesions, fibrosis, atelectasis, and upper and lower lung) were revealed in HIV-positive and HIV-negative patients. Similarly, significant differences in the characteristics and locations of lesions (cavities, miliary lesions, fibrosis, atelectasis, and upper and lower lung) were revealed in a patient with TLC ≤ 1200 and TLC > 1200.

Conclusion

The study highlights significant differences in the characteristics and locations of tuberculosis lesions about HIV status and total lymphocyte count levels among pulmonary TB patients. HIV-positive individuals exhibited distinct patterns of TB lesions compared to their HIV-negative counterparts, indicating the impact of HIV on TB disease progression. Furthermore, variations in lesion characteristics were also observed based on TLC levels, with notable differences between patients with TLC ≤ 1200 cells/μL and those with TLC > 1200 cells/μL. These findings underscore the importance of considering both HIV status and TLC in the assessment and management of TB in affected individuals. TLC can serve as an alternative to CD4 measurement in situations where access to CD4 testing is limited.

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2025-02-14
2025-11-05

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References

  1. National Guidelines for Medical Services for the Management of TuberculosisMinistry of Health of the Republic of Indonesia.2020 Available from: https://tbindonesia.or.id/download/9840/?tmstv=1697763572
    [Google Scholar]
  2. LongoD.L. FauciA.S. The human retroviruses. In: Loscalzo J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, Eds. Harrison’s Principles of Internal Medicine.20th ed LoscalzoJ. FauciA.S. KasperD.L. HauserS.L. LongoD.L. JamesonJ.L. New YorkMcGraw-Hill202215211527
     [Google Scholar]
  3. KonO.M. Tuberculosis in Clinical Practice.Cham, SwitzerlandSpringer202110.1007/978‑3‑030‑75509‑6
     [Google Scholar]
  4. Global tuberculosis report20212021 Available from: https://www.who.int/publications/i/item/9789240037021
  5. Health Profile of North Sumatra Province 2019Medan: North Sumatra Provincial Health Office2020
     [Google Scholar]
  6. Sereti I, Bisson GP, Meintjes G, editors. HIV and Tuberculosis: A Formidable Alliance.ChamSpringer201910.1007/978‑3‑030‑29108‑2
     [Google Scholar]
  7. Ministry of health directorate general of disease prevention and control.2019 Available from: https://siha.kemkes.go.id/portal/files_upload/buku_petunjukFINAL.pdf
  8. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendations for a public health approach.2013 Available from: https://www.who.int/publications/i/item/9789241549684
  9. QintharaM.H. SidipratomoP. BustamamN. Comparison of chest x-ray lesion locations in pulmonary tuberculosis patients with and without hiv infection.Medika Kartika J Med Health20214547148210.35990/mk.v4n5.p471‑482
     [Google Scholar]
  10. PeerV. SchwartzN. GreenM.S. Gender differences in tuberculosis incidence rates—A pooled analysis of data from seven high-income countries by age group and time period.Front. Public Health20231099702510.3389/fpubh.2022.99702536703824
     [Google Scholar]
  11. LiuH. ZhangX.G. HuangX.L. Dynamic observation and analysis of T lymphocyte subpopulations in patients with active pulmonary tuberculosis in different age groups.J Hebei Med Univ20163708889892
     [Google Scholar]
  12. KisemboH.N. BoonS.D. DavisJ.L. Chest radiographic findings of pulmonary tuberculosis in severely immunocompromised patients with the human immunodeficiency virus.Br. J. Radiol.2012851014e130e13910.1259/bjr/7070409921976629
     [Google Scholar]
  13. PadyanaM. BhatR. DineshaM. NawazA. HIV-tuberculosis: A study of chest X-ray patterns in relation to CD4 count.N. Am. J. Med. Sci.20124522122510.4103/1947‑2714.9590422655281
     [Google Scholar]
  14. AffusimC. AbahV. KesiemeE.B. AnyanwuK. SalamiT.A.T. EifediyiR. The effect of low CD4+ lymphocyte count on the radiographic patterns of HIV patients with pulmonary tuberculosis among Nigerians.Tuberc. Res. Treat.201320131410.1155/2013/53576923431432
     [Google Scholar]
  15. WuanA.O. Herlinalt Gloria BanunuA. KambunoN.T. Total lymfosit count (TLC) with CD4 in HIV/AIDS patients at Kupang.J. Law Technol.201982707510.29238/teknolabjournal.v8i2.189
     [Google Scholar]
/content/journals/chr/10.2174/011570162X330293250206093453
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Correlation of Total Lymphocyte Count, Human Immunodeficiency Virus Infection Status, and Tuberculosis Lesions on Chest X-ray: Can TLC Be an Alternative to CD4?
Cur. HIV Res. 23, 99 (2025); https://doi.org/10.2174/011570162X330293250206093453
/content/journals/chr/10.2174/011570162X330293250206093453
/content/journals/chr/10.2174/011570162X330293250206093453
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  • Article Type:     Research Article
Keyword(s): AIDS; CD4; chest X-ray; HIV; TLC; tuberculosis

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