Pulmonary tuberculosis and HIV seropositivity at the Principal Hospital of Dakar, Senegal

In a prospective survey conducted in 1990 in the Principal Hospital of Dakar, pulmonary tuberculosis was 2.3 times more frequent in HIV seropositive patients (12.5 %) than in HIV seronegative patients. We studied 22 cases of pulmonary tuberculosis in HIV+ patients and compared them with a control group of HIV- patients admitted for pulmonary tuberculosis. Tuberculosis occurred in 6 out of 22 asymptomatic HIV + patients, in 15 out of 22 patients with clinical AIDS and in 1 patient with ARC syndrome. Clinical signs were the same as in controls, except for patients with advanced AIDS who developed cardinal signs. TB intra-dermal reactions were more often negative in HIV + patients, notably those with HDV1, expressing immunodepression. Radiological images were typical in 81 % of patients and in 86 % of controls. However, concomitant infections were common in both groups, with atypical radiology and hyperleucocytosis. At light microscopy, there was no difference in the frequency of acid and alcohol fast bacilli between the two groups. The mortality rate was increased in HIV + patients, but this was not due to tuberculosis. Relapses were frequent in both groups, due to poor compliance with treatment. © 1993.