HIV positivity in presumptive tuberculosis cases in a tertiary respiratory care institute in New Delhi, India

Background: Routine screening of presumptive tuberculosis (TB) patients for HIV was advised by the Treatment and Operational Guidelines of TB in India in 2016. This was in contrast to the earlier policy in which only diagnosed TB cases underwent HIV screening. Keeping this in mind, our study was carried to look at the prevalence of HIV in presumptive TB cases in a tertiary respiratory disease hospital in New Delhi, India. Materials and Methods: This prospective observational study was carried out from 2015 to 2017 in which patients (>18 years of age) attending the outpatient department diagnosed as presumptive TB were enrolled. They underwent sputum examination in Revised National TB Control Programme Designated Microscopy Centre by fluorescence microscopy/Ziehl–Neelsen staining technique for the diagnosis of PTB, and they were taken to Integrated Counselling and Testing Centre in our hospital. Fine-needle aspiration cytology from lymph nodes and pleural or ascitic fluid studies were also done as per requirement for the diagnosis of extrapulmonary tuberculosis. Pretest counseling and HIV test were performed after informed consent. Results: Forty out of 1020 enrolled patients were HIV positive (3.9%). Fifteen out of 617 patients who were not suffering from TB came out to be HIV positive (2.4%). Our strategy led to an enhanced case finding of 15/25 (60%) new HIV-positive patients. Conclusion: Routine HIV screening in presumptive TB patients is a viable model to increase the case finding of HIV patients.