Perbandingan Lokasi dan Karakteristik Lesi pada Foto Thoraks Pasien Tuberkulosis Paru dengan dan Tanpa Infeksi HIV di RSUP H. Adam Malik

Abstract

Background: Tuberculosis (TB), caused by Mycobacterium tuberculosis, often becomes a comorbidity in individuals infected with Human Immunodeficiency Virus (HIV), the cause of Acquired Immunodeficiency Syndrome (AIDS). HIV-positive individuals have a 30-fold higher risk of contracting TB compared to non-HIV individuals. Assessment of HIV-TB disease progression commonly relies on measuring CD4 cell counts. However, in areas with limited access, the World Health Organization (WHO) recommends using Total Lymphocyte Count (TLC) ≤ 1200 cells/μL as an alternative. Additionally, chest X-rays, a widely accessible radiological method, aid in diagnosing TB in HIV-positive patients, complementing TLC in assessing disease progression in limited facilities. Objective: To analyze the differences in the location and characteristics of TB lesions based on HIV status and TLC levels. Methods: A case-control study was conducted at RSUP H. Adam Malik Medan on pulmonary TB patients from December 2021 to December 2022, meeting inclusion criteria. Evaluation of TB lesion locations and characteristics was performed by two researchers, while HIV status and TLC data were extracted from medical records. Results: The study involved 154 subjects, including 77 HIV-positive and 77 non- HIV individuals. The percentage of male participants was 81.8%, with an average age of 43.36 ± 14.39 years. Chi-square tests revealed significant differences in the characteristics and locations of lesions based on HIV status (cavities, miliary lesions, fibrosis, atelectasis, and upper and lower lung fields), with significant P-values (P < 0.05). Similarly, chi-square tests based on TLC indicated significant differences in lesion characteristics and locations, with significant P-values (P < 0.05). Conclusion: Significant differences exist in the characteristics and locations of TB lesions based on HIV status and TLC levels.