PT  - JOURNAL ARTICLE
AU  - Ana Patrícia Gomes da Rocha Dias
AU  - Bruno von Amann
AU  - João Costeira
AU  - Carlos Gomes
AU  - Cristina Bárbara
TI  - Extrapulmonary tuberculosis in HIV infected patients admitted to the hospital
AID  - 10.1183/13993003.congress-2016.PA2761
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA2761
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA2761.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA2761.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - Introduction: Extrapulmonary tuberculosis (EPTB) is more common in patients infected with the Human Immunodeficiency Virus (HIV). In Portugal, extrapulmonary lesions occur in approximately 50% of all tuberculosis (TB) cases in this population.Aims and objectives: to identify the EPTB sites in HIV patients and relate them with immune status and survival rate.Methods: retrospective review of all HIV patients admitted to our pulmonology department with EPTB between 2000 and 2015, regarding their demographic characteristics, CD4 lymphocyte cell counts (LCC), risk factors for tuberculosis and in-hospital mortality.Results: 112 patients were identified. 65,2% were drug users. The most common presentation was the miliary radiological pattern as a sole manifestation of disseminated disease (49,1%) followed by the lymph nodes (31,3%), the brain, meninges and pleura (8,9% each). For any EPTB site, a miliary radiological pattern was also present in 71,9% of the cases. Pulmonary involvement occurred in 86,6% of the cases. Most patients (81,3%) had CD4 LCC <200/μl. Mean CD4 LCC was lower in patients with miliary TB (108,4±139,3 vs 241,8±266,8). Meningeal TB cases had the lowest mean CD4 LCC (31,4±35,3/μl). Twenty-one (18,8%) patients died. Brain, meningeal and pleural TB had the highest mortality rates (30%). Mortality was similar for patients with CD4 LCC ≥200/μl and < 200/μl (13,3%vs15,4%).Conclusions: Pulmonary involvement was common and miliary disease occurred in most cases. CD4 LCC were low and meningeal TB cases had the lowest values. Mortality was higher in patients with central nervous system TB, as described in the literature. CD4 LCC <200/μl were not associated with significantly higher mortality.