Pulmonary Tuberculosis (PTB) is a common manifestation in adults with TB-HIV co-infection. However, as the immunity gets worse, HIV-infected individuals more often develop extrapulmonary and disseminated TB. The Incidence of extrapulmonary TB (EPTB) has increased after the epidemic of HIV infection. It is responsible for 10-50% of all TB case among HIV negative individuals, while in HIV positive group, it occurs in 38-80%.1 Several studies found that up to 50% TB-HIV patients die during TB treatment.2,3 In Thailand, verbal autopsies, laboratorium data, and medical records of TB-HIV patients who die during TB treatment state that TB is the cause of death in 27% of those patients, whereas more than a half of them were disseminated and Multi Drug Resistant TB (Complicated EPTB).2
In many part of the world, many studies had mentioned susceptibility of HIV patients to develop extrapulmonary TB.4-6,8 Additionally, in the recent guideline to improve diagnosis and treatment of extrapulmonary TB, World Health Organization (WHO) states EPTB in HIV-infected person has become a new clinical problem especially in remote area where advance modality supporting diagnosis and treatment are unavalaible. Although pulmonary TB is the most common presentation of TB disease, it can involve any organ in the body. Extrapulmonary Tuberculosis is defined as the isolated occurrence of TB in any part of the body other than lungs such as lymph nodes, abdomen, genitourinary system, musculoskeletal and meninges. Mycobacteria may spread to any organ of the body through lymphatic or haematogenous dissemination and lie dormant for years at a particular site before causing disease. Manifestations may relate to the system involved, or simply as prolonged fever and non specific systemic symptoms. Tuberculosis is a worldwide disease and one of the major health problems of Indonesia. Extrapulmonary tuberculosis is increasing all over the world. However, only limited data is available about the situation of EPTB in developing countries including Indonesia, hence diagnosis may be elusive and is usually delayed.1,3 This study reviews the general spectrum of cases diagnosed with EPTB at a large HIV referral center (POKDISUS) and presents their key demographics, dominant infection sites and the laboratory findings.

Key words: Extrapulmonary Tuberculosis, HIV