Clinical, immunological and epidemiological correlations of Tuberculosis / HIV Coinfection in patients Infected with HIV in Olt County in Romania between 2005-2015

Background: Global increase of people infected with HIV (PIH) is causing changes in tuberculosis (TB) clinical and epidemiological data. HIV infection increases up to 20 times the chance of progression from latent infection to active forms of TB. Purpose: The paper aims to assess patients with TB-HIV coinfection in Olt county of Romania registered in Regional Center for Monitoring and Evaluation of HIV/AIDS of Craiova (demographics, symptoms, immunologic evaluation, TB type, TB related number of treatments) in order to identify risk factors for progression to active TB in this subset of patients. Material and Method: We performed a retrospective descriptive study using records of PIH between 2005-2015. We identified patients registered with TB-HIV. Results: We analyzed 256 medical charts of PIH of which 76 (29.68%) had at least one treatment for TB. Women (52.7%) and rural residence (54%) predominated. Majority was formed of those born in 1980-1990 (86.84%), with predominance of Romanians (93.4%) compared to the Roma. Regarding all TB diagnoses (pulmonary and extrapulmonary) 48 were new cases, other 28 presented relapses, 2 cases presented multidrug-resistance. TB and HIV have been diagnosed at the same time in 25 cases (32.89%). At the time of TB diagnosis 40 patients had CD4 + lymphocytes count <200 cells/ ml. We also noticed high incidence of hepatitis B among those with HIV/TB coinfection (18.42%). Conclusions: Higher risk of developing active TB in patients with HIV infection is correlated with severe immunosuppression, atypical clinical expression, radiological and bacteriological findings.