Factores de riesgo y complicaciones asociados a tuberculosis en pacientes con hiv sida Hospital José Daniel Rodríguez Maridueña
Fecha
2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
Antecedentes: La coinfección VIH y tuberculosis contribuye al incremento del riesgo de
mortalidad de los pacientes, al menos un tercio de los 38,6 millones de personas que hay en el
mundo infectadas por el VIH también están infectadas por el bacilo de la TB. Método: Se
realizó un estudio descriptivo, observacional, de corte transversal que incluye 200 pacientes
con coinfección TB/VIH SIDA, se recolectan los datos de las variables estudiadas, se
determinan sus frecuencias y se analizan. Resultados: Las variables que sobresalieron en esta
investigación son: sexo masculino 64 %. Grupo etario: 25 a 44 años 60%. Nivel de educación
40% (n= 80) primaria. IMC: peso normal 75.5%; Antecedentes de hábitos nocivos: No consumo
de drogas 30%. Tratamiento antirretroviral TDF FTC EFV 86%; Carga viral: mayor a 1000 en el
60.5%. Conteo de linfocitos de CD4 97% en valores menor de 200 mm3. Métodos de
diagnóstico de tuberculosis: Baciloscopia 86%, Clínica +RX 89%. Tratamiento antituberculoso:
El 84% HRZE, 14.5% 2HRZE/4HR. Presentación de tuberculosis: pulmonar: 32%; Miliar 3.5%;
Gastrointestinal 24%. El 85% no presentó comorbilidades. Enfermedades oportunistas:
Histoplasmosis 15,5%; Sífilis 57%. Conclusiones: La tuberculosis en pacientes VIH/SIDA, se
presenta principalmente, en pacientes masculinos en un rango de edad 25-44 años, la ausencia
de hábitos nocivos no exime de su presentación y no siempre se asocia con pérdida de peso.
Respecto a su relación con el VIH, el tiempo de evolución y la carga viral de VIH, son
proporcionales al riesgo de tuberculosis, lo contrario ocurre con el conteo de linfocitos CD4+,
que se mantuvieron en valores bajos pese a que los pacientes recibían TARV.
Background: HIV and tuberculosis coinfection contributes to the increased risk of patient mortality, at least one third of the 38.6 million people in the world infected with HIV are also infected with the TB bacillus. Method: A descriptive, observational, cross-sectional study was carried out that included 200 patients with TB / HIV AIDS coinfection, the data of the studied variables were collected, their frequencies were determined and they were analyzed. Results: The variables that stood out in this research are: male sex 64%. Age group: 25 to 44 years 60%. Level of education 40% (n = 80) primary. BMI: normal weight 75.5%; History of harmful habits: No drug use 30%. Antiretroviral treatment TDF FTC EFV 86%; Viral load: greater than 1000 in 60.5%. CD4 lymphocyte count 97% in values less than 200 mm3. Tuberculosis diagnostic methods: Bacilloscopy 86%, Clinic + RX 89%. Anti-tuberculosis treatment: 84% HRZE, 14.5% 2HRZE / 4HR. Presentation of tuberculosis: pulmonary: 32%; Miliary 3.5%; Gastrointestinal 24%. 85% did not present comorbidities. Opportunistic diseases: Histoplasmosis 15.5%; Syphilis 57%. Conclusions: Tuberculosis in HIV / AIDS patients occurs mainly in male patients in an age range 25-44 years, the absence of harmful habits does not exempt its presentation and is not always associated with weight loss. Regarding its relationship with HIV, the time of evolution and the HIV viral load are proportional to the risk of tuberculosis, the opposite occurs with the CD4 + lymphocyte count, which remained low despite the patients receiving ART
Background: HIV and tuberculosis coinfection contributes to the increased risk of patient mortality, at least one third of the 38.6 million people in the world infected with HIV are also infected with the TB bacillus. Method: A descriptive, observational, cross-sectional study was carried out that included 200 patients with TB / HIV AIDS coinfection, the data of the studied variables were collected, their frequencies were determined and they were analyzed. Results: The variables that stood out in this research are: male sex 64%. Age group: 25 to 44 years 60%. Level of education 40% (n = 80) primary. BMI: normal weight 75.5%; History of harmful habits: No drug use 30%. Antiretroviral treatment TDF FTC EFV 86%; Viral load: greater than 1000 in 60.5%. CD4 lymphocyte count 97% in values less than 200 mm3. Tuberculosis diagnostic methods: Bacilloscopy 86%, Clinic + RX 89%. Anti-tuberculosis treatment: 84% HRZE, 14.5% 2HRZE / 4HR. Presentation of tuberculosis: pulmonary: 32%; Miliary 3.5%; Gastrointestinal 24%. 85% did not present comorbidities. Opportunistic diseases: Histoplasmosis 15.5%; Syphilis 57%. Conclusions: Tuberculosis in HIV / AIDS patients occurs mainly in male patients in an age range 25-44 years, the absence of harmful habits does not exempt its presentation and is not always associated with weight loss. Regarding its relationship with HIV, the time of evolution and the HIV viral load are proportional to the risk of tuberculosis, the opposite occurs with the CD4 + lymphocyte count, which remained low despite the patients receiving ART
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TUBERCULOSIS, SINDROME DE INMUNODEFICIENCIA HUMANA, VIRUS DE INMUNODEFICIENCIA HUMANA, COINFECCION, INFECCIONES POR VIH, FACTORES DE RIESGO, EPIDEMIOLOGIA DESCRIPTIVA, HOSPITAL DE INFECTOLOGIA DR. JOSE DANIEL RODRIGUEZ MARIDUEÑA, CANTON GUAYAQUIL, ECUADOR