Tuberculous pericarditis in HIV co-infected compared to those without HIV co-infection

Abstract

Introduction: Tuberculosis (TB) pericarditis is a relatively rare form of tuberculosis which has been on the decline. However, the advent of the human immunodeficiency virus (HIV) pandemic has brought about the resurgence of tuberculosis pericarditis and an even poorer prognosis for patients with HIV co-infection. Objectives: The aim is to describe the baseline characteristics of tuberculous pericarditis patients and to assess the impact of HIV on the clinical presentation of this disease. Methods: The study describes baseline data from a randomised clinical trial which explored the use of adjunctive corticosteroids in management of TB pericarditis then went on to compare HIV co-infected patients versus those without HIV co-infection using logistic regression. Results: There were 1394 patients enrolled into the study, 64% were HIV positive, 19% were HIV negative and 17% had an unknown HIV status. Forty four percent of the participants were female and age had a positively skewed distribution with median 36 years (IQR: of 29-46). HIV co-infected patients were younger with OR 0.97(95% CI: 0.96-0.98), more likely to have previously had TB with OR 2.15(95% CI: 1.25-3.72), had a more acute illness with OR 0.99(95% CI: 0.99-1.00), had lower hemoglobin with OR 0.72(95% CI: 0.67-0.78), lower White Cell Count, (WCC) with OR 0.90(95% CI: 0.86-0.96) and higher globulin with OR 1.07(95% CI: 1.05-1.09). Conclusion: HIV co-infected participants are younger, more likely to have been previously diagnosed with TB, have a more acute illness, lower haemoglobin, lower WCC and higher globulin.