Pattern of Opportunistic Pulmonary Infections in HIV Sero-positive Subjects: Observations from Pondicherry, India

Prospective analysis for a period of six-and-a-half years was done in 190 patients with HIV infection, which showed post-primary tuberculosis with sputum positive for acid-fast bacilli in 65% of cases. Extrapulmonary forms of tuberculosis especially lymph nodes infection was more frequent. Cervical group of lymph node involvement was the commonest presentation. Procedures such as FNAC/biopsy of lymph nodes and pleura provided the immediate diagnostic yields. These procedures must be considered early in the course of illness of HIV infected patients with suspected extrapulmonary and disseminated tuberculosis. Tuberculosis constitutes a common pathology with an appreciable mortality in disseminated subjects. Majority of patients with tuberculosis responded to 2EHRZ/7HR therapy indicating infection by Mycobacterium tuberculosis rather than by atypical mycobacteria, without any serious adverse reactions. Retrospective analysis of two groups (February 1991-May 1994) and (June 1994-October 1997) shows a significant increase in disseminated tuberculosis and Pneumocystis carini pneumonia indicating late stage of HIV disease.