Abstract：
High proportion of TB in people living with HIV (PLHIV) is undiagnosed. Due to this active TB case finding is recommended for HIV clinics in high TB burden countries. Presently sputum examination and chest radiography are frontline tests recommended for HIV infected TB presumptives. Abdominal TB which occurs frequently in PLHIV may be missed even by existing programmatic intensified case finding protocols. This study evaluated the routine use of ultrasonography (USG) for active case finding of abdominal TB in HIV clinics.
Retrospective analysis of eight years\' data from an HIV Clinic in a TB hospital in India. Patients underwent chest x-ray, sputum examination, USG abdomen and routine blood tests at entry to HIV care. Case forms were scrutinized for diagnosis of TB, USG findings and CD4 cell counts. Abdominal TB was classified as probable or possible TB. Probable TB was based on presence of two major USG (abdomen) findings suggestive of active TB, or one major USG finding with at least two minor USG findings or at least two symptoms, or any USG finding with microbiologically confirmed active TB at another site. Possible TB was based on the presence of one major USG finding, or the presence of two minor USG findings with at least two symptoms. Bacteriological confirmation was not obtained.
Eight hundred and eighty-nine people PLHIV underwent a baseline USG abdomen. One hundred and thirteen of 340 cases already diagnosed with TB and 87 of the 91 newly diagnosed with TB at time of HIV clinic registration had abdominal TB. Non-abdominal symptoms like weight loss, fever and cough were seen in 53% and 22% cases had no symptoms at all. Enlarged abdominal lymph nodes with central caseation, ascitis, splenic microabsesses, bowel thickening and hepatosplenomegaly were the USG findings in these cases.
Abdominal TB is a frequent TB site in PLHIV presenting with non-abdominal symptoms. It can be easily detected on basis of features seen on a simple abdominal ultrasound. Abdominal USG should be essential part of intensified TB case finding algorithms for HIV infected people living in high TB burden settings.
Retrospective analysis of eight years\' data from an HIV Clinic in a TB hospital in India. Patients underwent chest x-ray, sputum examination, USG abdomen and routine blood tests at entry to HIV care. Case forms were scrutinized for diagnosis of TB, USG findings and CD4 cell counts. Abdominal TB was classified as probable or possible TB. Probable TB was based on presence of two major USG (abdomen) findings suggestive of active TB, or one major USG finding with at least two minor USG findings or at least two symptoms, or any USG finding with microbiologically confirmed active TB at another site. Possible TB was based on the presence of one major USG finding, or the presence of two minor USG findings with at least two symptoms. Bacteriological confirmation was not obtained.
Eight hundred and eighty-nine people PLHIV underwent a baseline USG abdomen. One hundred and thirteen of 340 cases already diagnosed with TB and 87 of the 91 newly diagnosed with TB at time of HIV clinic registration had abdominal TB. Non-abdominal symptoms like weight loss, fever and cough were seen in 53% and 22% cases had no symptoms at all. Enlarged abdominal lymph nodes with central caseation, ascitis, splenic microabsesses, bowel thickening and hepatosplenomegaly were the USG findings in these cases.
Abdominal TB is a frequent TB site in PLHIV presenting with non-abdominal symptoms. It can be easily detected on basis of features seen on a simple abdominal ultrasound. Abdominal USG should be essential part of intensified TB case finding algorithms for HIV infected people living in high TB burden settings.
摘要：
艾滋病毒感染者（PLHIV）中结核病的比例很高。由于这种活跃的结核病病例发现被建议用于高结核病负担国家的艾滋病毒诊所。目前，痰液检查和胸部X线检查是建议用于HIV感染的结核病推定的一线检查。即使通过现有的程序性强化病例发现方案，PLHIV中经常发生的腹部结核病也可能被错过。这项研究评估了超声检查（USG）在HIV诊所中积极发现腹部结核病的常规应用。
对印度一家结核病医院的HIV诊所8年数据进行回顾性分析。患者接受了胸部X光检查,痰液检查,进入艾滋病毒护理时的USG腹部和常规血液检查。病例表格被仔细检查以诊断结核病，USG发现和CD4细胞计数。腹部TB被分类为可能或可能的TB。可能的结核病是基于存在两个主要的USG（腹部）发现，提示活动性结核病。或一个主要的USG发现，至少有两个次要的USG发现或至少两个症状，或任何USG发现在另一个地点有微生物学证实的活动性结核病。可能的结核病是基于USG的一项主要发现，或存在两个轻微的USG发现，至少有两个症状。未获得细菌学证实。
八百八十九人PLHIV接受了基线USG腹部。在HIV临床登记时，已经诊断出结核病的340例中有113例，在新诊断出结核病的91例中有87例患有腹部结核病。非腹部症状，比如体重减轻，53％的病例出现发烧和咳嗽，22％的病例根本没有症状。腹部淋巴结肿大伴中央区，腹膜炎,脾微凹陷,肠管增厚和肝脾肿大是这些病例的USG表现.
腹部结核是PLHIV中常见的结核部位，表现为非腹部症状。它可以很容易地检测到的特征在一个简单的腹部超声。腹部USG应该是强化结核病病例发现算法的重要组成部分，用于生活在高结核病负担环境中的HIV感染者。
对印度一家结核病医院的HIV诊所8年数据进行回顾性分析。患者接受了胸部X光检查,痰液检查,进入艾滋病毒护理时的USG腹部和常规血液检查。病例表格被仔细检查以诊断结核病，USG发现和CD4细胞计数。腹部TB被分类为可能或可能的TB。可能的结核病是基于存在两个主要的USG（腹部）发现，提示活动性结核病。或一个主要的USG发现，至少有两个次要的USG发现或至少两个症状，或任何USG发现在另一个地点有微生物学证实的活动性结核病。可能的结核病是基于USG的一项主要发现，或存在两个轻微的USG发现，至少有两个症状。未获得细菌学证实。
八百八十九人PLHIV接受了基线USG腹部。在HIV临床登记时，已经诊断出结核病的340例中有113例，在新诊断出结核病的91例中有87例患有腹部结核病。非腹部症状，比如体重减轻，53％的病例出现发烧和咳嗽，22％的病例根本没有症状。腹部淋巴结肿大伴中央区，腹膜炎,脾微凹陷,肠管增厚和肝脾肿大是这些病例的USG表现.
腹部结核是PLHIV中常见的结核部位，表现为非腹部症状。它可以很容易地检测到的特征在一个简单的腹部超声。腹部USG应该是强化结核病病例发现算法的重要组成部分，用于生活在高结核病负担环境中的HIV感染者。
