A preliminary survey for human immunodeficient virus (HIV) infections in tuberculosis and melioidosis patients in Ubon Ratchathani, Thailand

Abstract

A preliminary survey was conducted for the prevalence of HIV infections in pulmonary tuberculosis and melioidosis patients in Ubon Ratchathani province, in Thailand, the second largest province in population which supplies labors to Bangkok metropolis. In this province, tuberculosis is prevalent in a higher rate than in most other provinces and melioidosis is endemic. Four HIV-seropositives were found in a total of 551 suspected and culture-positive cases of pulmonary tuberculosis, while no HIV-seropositive was found in 121 melioidosis patients. In view of the rapidly expanding HIV-infections in Thailand, a strict watch will be needed on the future epidemiological status of HIV-infection in tuberculous patient.

PIP: HIV infection develops not only to AIDS, but it is also a leading risk factor for the development of many other infectious diseases due to the depletion of T lymphocytes such as the interrelated prevalence of tuberculosis (TB) and AIDS. Surveillance conducted in the 1988-1989 in the US and other recent studies found a serious epidemiological relation. Thailand has an endemic disease, melioidosis, caused by P. pseudomallei living in environmental soil and water. The disease takes various clinical types; localized, systemic, acute, subacute, chronic, and inapparent; presenting symptoms undistinguishable from many other infectious diseases. Pulmonary melioidosis shows a clinical feature similar to lung tuberculosis which occurs more easily in the individuals of impaired immunity, such as diabetes patients. According to available literatures, one case of recurrent melioidosis has been reported in Thailand as a complication of AIDS. The patient was a German homosexual male who had been living in the country for more than 10 years and showed a fatal course with interstitial pneumonitis. Ubon Ratchathani province, Thailand, is an area endemic for both TB and melioidosis, as well as a major supplier of laborers to Bangkok. A preliminary survey was conducted for the prevalence of HIV infections in pulmonary TB and melioidosis patients in Ubon Ratchathani province. TB was found to be prevalent in the province to a greater extent than in most other provinces and melioidosis is endemic. Four individuals were found to be HIV-seropositive amid a total 551 suspected and culture-positive cases of pulmonary TB, while no HIV-seropositive case was found among 121 melioidosis patients. In view of the rapidly expanding HIV-infections in Thailand, careful attention will have to be given to the future epidemiological status of HIV infection in TB patients.