Clinicoradiological Profile and Neutrophil-to-lymphocyte Ratio in Human Immunodeficiency Virus–tuberculosis Coinfection: A Descriptive Study

Abstract Background: Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection remain significant public health challenges, particularly in regions with high endemicity. Coinfection complicates clinical presentation and management, with increased morbidity and mortality. Immune dysregulation markers such as the neutrophil-to-lymphocyte ratio (NLR) have emerged as potential tools for assessing disease severity and progression. Materials and Methods: A descriptive study was conducted at a tertiary hospital, including both retrospective and prospective patients diagnosed with TB–HIV coinfection. Clinical, radiological, hematological, and biochemical data were systematically collected and analyzed. Diagnosis was made using clinical features combined with radiological, microbiological, and histopathological evidence. Results: The study enrolled 192 patients (96 HIV only controls and 96 HIV-TB cases), predominantly middle-aged males presenting with common symptoms including weight loss, fever, and cough of variable duration. Hematological findings highlighted anemia and elevated but variable NLR levels. Biochemical tests indicated mild liver enzyme elevations and hypoalbuminemia. Radiological findings were diverse, mainly marked by pulmonary infiltrates with cavitary lesions and pleural effusions. Normal chest X-rays were noted in a small proportion. Conclusion: HIV–TB coinfection presents with variable clinical, laboratory, and imaging features. NLR serves as a feasible, inexpensive biomarker for systemic inflammation. Early integration of symptom-based screening and multimodal diagnostics is critical for prompt identification and management in high-risk groups.