TY - JOUR
T1 - TB disease patterns by HIV and diabetes status
AU - Weber, S. F.
AU - Ruby, L. C.
AU - Heller, T.
AU - Hande, M.
AU - Shastry, B. A.
AU - Acharya, R. V.
AU - Bhat, R.
AU - Shankar, S.
AU - Prabhu, M.
AU - Mohapatra, A. K.
AU - Magazine, R.
AU - Kadavigere, R.
AU - Denkinger, C. M.
AU - Gehring, S.
AU - Bélard, S.
AU - Saravu, K.
N1 - Publisher Copyright:
C 2022 The Union.
PY - 2022/8/1
Y1 - 2022/8/1
N2 - BACKGROUND: TB is commonly categorised as pulmonary (PTB) or extrapulmonary TB (EPTB). Knowledge of TB disease patterns (PTB and/or EPTB) and determining risk factors remains limited.METHODS: This was a prospective cohort study using point-of-care ultrasound (POCUS) in Indian patients with presumed TB. Clinical and imaging data were used to develop refined case definitions for PTB, concurrent PTB and EPTB (PTB + EPTB) and EPTB without PTB (EPTB). These groups were analysed by HIV (HIV+/-) and diabetes mellitus (DM+/-) status.RESULTS: Of 172 HIV-/DM- patients with TB, 48% had PTB, 23% PTB + EPTB and 29% had EPTB, totalling 52% with any EPTB (PTB + EPTB or EPTB). In HIV+/DM- patients with TB (n = 35), 6% had PTB, 40% had PTB + EPTB and 54% had EPTB, accounting for 94% with EPTB. In HIV-/DM+ patients with TB (n = 61), 61% had PTB, 28% had PTB + EPTB and 11% had EPTB, representing 39% with EPTB.CONCLUSION: Refined case definitions revealed high proportions of EPTB even without HIV or DM. HIV further altered the TB disease pattern towards EPTB and DM towards PTB. Therefore, the dichotomy between PTB or EPTB does not represent the actual spectrum of TB disease. EPTB should receive higher priority in research and clinical practice.
AB - BACKGROUND: TB is commonly categorised as pulmonary (PTB) or extrapulmonary TB (EPTB). Knowledge of TB disease patterns (PTB and/or EPTB) and determining risk factors remains limited.METHODS: This was a prospective cohort study using point-of-care ultrasound (POCUS) in Indian patients with presumed TB. Clinical and imaging data were used to develop refined case definitions for PTB, concurrent PTB and EPTB (PTB + EPTB) and EPTB without PTB (EPTB). These groups were analysed by HIV (HIV+/-) and diabetes mellitus (DM+/-) status.RESULTS: Of 172 HIV-/DM- patients with TB, 48% had PTB, 23% PTB + EPTB and 29% had EPTB, totalling 52% with any EPTB (PTB + EPTB or EPTB). In HIV+/DM- patients with TB (n = 35), 6% had PTB, 40% had PTB + EPTB and 54% had EPTB, accounting for 94% with EPTB. In HIV-/DM+ patients with TB (n = 61), 61% had PTB, 28% had PTB + EPTB and 11% had EPTB, representing 39% with EPTB.CONCLUSION: Refined case definitions revealed high proportions of EPTB even without HIV or DM. HIV further altered the TB disease pattern towards EPTB and DM towards PTB. Therefore, the dichotomy between PTB or EPTB does not represent the actual spectrum of TB disease. EPTB should receive higher priority in research and clinical practice.
UR - https://www.scopus.com/pages/publications/85135371370
UR - https://www.scopus.com/inward/citedby.url?scp=85135371370&partnerID=8YFLogxK
U2 - 10.5588/ijtld.21.0693
DO - 10.5588/ijtld.21.0693
M3 - Article
C2 - 35898145
AN - SCOPUS:85135371370
SN - 1027-3719
VL - 26
SP - 733
EP - 740
JO - The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
JF - The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
IS - 8
ER -
