Clinical and radiographic features of HIV-related pulmonary tuberculosis according to the level of immunosuppression

Rev Soc Bras Med Trop. 2007 Nov-Dec;40(6):622-6. doi: 10.1590/s0037-86822007000600004.

Abstract

Medical charts and radiographs from 38 HIV-infected patients with positive cultures for Mycobacterium tuberculosis from sputum or bronchoalveolar lavage were reviewed in order to compare the clinical, radiographic, and sputum bacilloscopy characteristics of HIV-infected patients with pulmonary tuberculosis according to CD4+ lymphocyte count (CD4). The mean age of the patients was 32 years and 76% were male. The median CD4 was 106 cells/mm(3) and 71% had CD4 < 200 cells/mm(3). Sputum bacilloscopy was positive in 45% of the patients. Patients with CD4 < 200 cells/mm(3) showed significantly less post-primary pattern (7% vs. 63%; p = 0.02) and more frequently reported weight loss (p = 0.04). Although not statistically significant, patients with lower CD4 showed lower positivity of sputum bacilloscopy (37% vs. 64%; p = 0.18). HIV-infected patients with culture-confirmed pulmonary tuberculosis had a high proportion of non-post-primary pattern in thoracic radiographs. Patients with CD4 lower than 200 cells/mm(3) showed post-primary patterns less frequently and reported weight loss more frequently.

Publication types

  • Comparative Study

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis
  • AIDS-Related Opportunistic Infections / diagnostic imaging
  • AIDS-Related Opportunistic Infections / immunology*
  • Adult
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count
  • Cross-Sectional Studies
  • Female
  • Humans
  • Immunosuppression Therapy
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Mycobacterium tuberculosis / isolation & purification*
  • Radiography
  • Sputum / microbiology
  • Tuberculosis, Pulmonary / diagnosis
  • Tuberculosis, Pulmonary / diagnostic imaging
  • Tuberculosis, Pulmonary / immunology*