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• W2034287279 abstract "L’avènement du VIH a contribué à l’augmentation du nombre de tuberculeux. Les signes cliniques et paracliniques des co-infectés TB/VIH sont polymorphes et fonction de l’état immunitaire. Déterminer les caractéristiques cliniques et paracliniques en fonction du taux de CD4. Étude rétrospective, à visée descriptive et comparative, analysant 450 dossiers des malades co-infectés TB/VIH. Elle a porté sur les dossiers des malades atteints de tuberculose pulmonaire à microscopie positive (TPM+) avec une sérologie VIH positive. Les dossiers ont été pris par groupe de taux de CD4 (< 200/mm3, de 200 à 350/mm3 et > 300/mm3), de façon successive et chronologique d’avril à septembre 2010 avec 150 malades par groupe de CD4. Parmi les 450 patients, 71,1 % étaient issus la tranche d’âge comprise entre 25 et 45 ans. Les signes cliniques sont d’autant plus importants que le taux de CD4 est bas. Ces signes sont dominés par la fièvre (93 %) et l’amaigrissement (62,7 %). Les cavernes (59,3 %), les infiltrats (38,7 %) et la localisation des lésions au sommet (72 %) sont plus représentées chez les patients du troisième groupe. En revanche, les lésions extrapulmonaires (adénopathies médiastinales, pleurésie) et la radiographie normale (9,3 %) étaient plus fréquentes chez les patients du premier groupe. La rareté des cavernes (22,3 % contre 59,3 % CD4 > 350) et les lésions associées étaient d’autant plus fréquentes que le patient est immunodéprimé. Les troubles hématologiques, hépatiques, rénaux étaient plus fréquents et sévères chez les malades fortement immunodéprimés. La tuberculose liée au VIH présente des caractéristiques cliniques, radiologiques, biologiques atypiques et des signes de sévérités lorsque l’immunodépression est importante. Correlation of the manifestations of tuberculosis and the degree of immunosuppression in patients with HIV. 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. To determines the clinical and paraclinical characteristics of TB related to different levels of CD4 lymphocytes. 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/mm3, of 200–350/mm3 and > 350/mm3), in a chronological fashion from April to September 2010 until there were 150 patients in each CD4 group. Among the 450 patients, 71.1% were between 25 and 45 years 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. HIV-associated tuberculosis has an atypical clinical, radiological, biological presentation and is more severe when there is significant immunosuppression." @default.
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• W2034287279 date "2013-09-01" @default.
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• W2034287279 title "Corrélations des manifestations de la tuberculose pulmonaire avec le degré d’immunodépression au VIH" @default.
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• W2034287279 doi "https://doi.org/10.1016/j.rmr.2013.01.003" @default.
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