Author(s): Padyana M, Bhat RV, Dinesha M, Nawaz A, Padyana M, Bhat RV, Dinesha M, Nawaz A
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Abstract BACKGROUND: Fight against human immunodeficiency virus (HIV) is incomplete without addressing problems associated with difficult diagnosis of tuberculosis in HIV-Tuberculosis coinfected patients. Chest X-ray is a primary tool to evaluate tuberculosis in HIV. AIM: To assess and compare various radiological patterns of pulmonary tuberculosis in HIV patients and compare these patterns in relation to CD4 counts. MATERIALS AND METHODS: Prospective cohort study was conducted in a tertiary hospital in South India from September 2009 to July 2011 with 200 HIV positive patients. WHO guidelines were used for diagnosis of HIV and tuberculosis. RESULTS: 27\% of the patients had sputum positive pulmonary tuberculosis, with higher incidence (33\%) among CD4 less than 200 as compared to CD4 more than 200 (14\%). Infiltration (39\%) followed by consolidation (30\%), cavity (11\%), and lymphadenopathy (9\%) seen with CD4 less than 200. Infiltration (37.5\%) followed by cavity (25\%) and miliary (25\%) with CD4 above 200. Bilateral (68.5\%) and mid and lower zones or all zone involvement more commonly seen. CONCLUSION: In patients with CD4 lower than 200 noncavitory infiltration and consolidation predominated. Involvement of lungs was atypical; diffuse or mid and lower zone involvement than classical upper lobe involvement. A high index of suspicion is necessary for the accurate and timely diagnosis of tuberculosis in HIV positive patients.
This article was published in N Am J Med Sci
and referenced in Journal of AIDS & Clinical Research