Hypercalcemia in patients with tuberculosis and HIV infections in Northwest Ethiopia

Objective To determine incidence of hypercalcemia among TB patients with and without HIV infection before and after anti-TB chemotherapy in tropical settings of Northwest Ethiopia. Methods Serum levels of calcium were determined using an inductively coupled plasma mass spectrometer from all subjects at baseline and from 60 TB patients (34 with HIV co-infection) at the end of an intensive phase of anti-TB chemotherapy. Results At baseline, significant difference was found between the mean albumin-adjusted calcium levels in TB patients with HIV (11.95±3.72) and controls (9.81±1.59) (P=0.03). Hypercalcemia (serum calcium of > 10.5 mg/dL) was observed in 62.2% and 43.2% of TB patients with and without HIV co-infection, respectively. The serum levels of calcium did not significantly change after anti-TB chemotherapy both in patients with (n = 34) and without (n = 26) HIV co-infection. Conclusions The present study suggests that TB itself appears not to be responsible for hypercalcemia; however, rates of hypercalcemia are high in TB and HIV co-infected patients in the tropical settings of Northwest Ethiopia, of rarely symptomatic. Anti-TB chemotherapy does not improve the incidence of hypercalcemia in both groups with HIV co-infection and without.