Correlation Between Clinical Manifestation and Radiological Findings In Pulmonary Tuberculosis-Human Immunodeficiency Virus Coinfection Patients In Sanglah Hospital, Bali, Indonesia

Abstract

Background: Tuberculosis (TB) mono-infection has radiological features and typical clinical manifestation that are easily recognized by clinicians. These radiological features and clinical manifestation are often found to show atypical features in subjects coinfected with Tuberculosis-Human Immunodeficiency Virus (HIV), making TB diagnosis and early management challenging to establish. Objective: This study aims to determine the relationship between clinical and radiological presentation of pulmonary TB patients with HIV coinfection at the Central General Hospital Sanglah, Bali. Methods: This research was an observational analytic study with a cross-sectional method. A total of 54 TB-HIV coinfected patients were analyzed to their sociodemographic characteristics, clinical manifestations and chest radiographic features. Results: The majority of subjects were of productive age (26-61 years), male (64.8%) and belonged to the heterosexual group (90.7%). Weight loss (75.9%), cough (64.8%) and oral candidiasis (53.7%) are the most common clinical manifestations found in subjects, especially in subjects with CD4+ >200 cells/mm3. Atypical radiological features such as infiltration/consolidation (59.3%), fibrosis (16.7%) and hillar lymphadenopathy (14.8%) are the most commonly obtained radiological features of the subjects. From the results of the bivariate analysis, it was found that radiological in the form of infiltration/consolidation were more commonly found in subjects with CD4+ <200 cells/mm3(OR=1.254; 95% CI 1.059-1.568). Conclusion: Based on the research that has been done, it can be concluded that there are no typical radiological features and clinical manifestation in patients with TB-HIV infection.