Radiographic features of pulmonary tuberculosis in HIV-infected patients with different severity of immunosuppression and deviant behavior
https://doi.org/10.18093/0869-0189-2018-28-2-211-216
Abstract
The objective of this study was to investigate radiological features of pulmonary tuberculosis in HIV-infected patients with different severity of immunosuppression and deviant behavior. Methods. This was a single-center total observational retrospective study. The study involved 257 patients with pulmonary tuberculosis and NIV-infection who was treated and followed at a penitentiary tuberculosis hospital. Results. Tuberculosis-associated lung lesions were diagnosed in 94.2% of patients. Extrapulmonary and generalized tuberculosis increased with worsening immunity. Majority of patients were 20 – 29 and 30 – 39 years old. Typical radiological features included lung root lesions due to hilar lymph node enlargement in patients with CD4 lymphocytes < 100 cells/µL. CD4 lymphocytes decrease < 100 cells/µL was more likely in patients with involvement of ≥ 3 lung lobes and less likely in patients with involvement of 1 or 2 lung segments. CD4 lymphocytes decrease < 100 cells/µL was associated with prominent lung tissue infiltration (39.0%); moderate infiltration of the lung tissue did not depend on immunosuppression. Cavitation ≤ 2 cm was frequent (76.9 – 96.0%), mostly in the right lung (36.4 – 53.8%) and did not depend on immunosuppression. Conclusion. The most prevalent pulmonary tuberculosis in HIV-infected patients was infiltrative tuberculosis independently on CD4 lymphocyte number.
About the Author
V. S. Borovitskiy
Branch Tuberculosis Hospital, Medical Unit No.43, Federal Penitentiary Service of Russian Federation
Russian Federation
Candidate of Medicine, phthisiatrician
Russian Federation
Candidate of Medicine, phthisiatrician
References
1. Flanigan T.P., Zaller N., Taylor L. et al. HIV and infectious disease care in jails and prisons: breaking down the walls with the help of academic medicine. Trans. Am. Clin. Climatol. Assoc. 2009; 120: 73–83.
2. Leung C.C. Reexamining the role of radiography in tuberculosis case finding. Int. J. Tuberc. Lung Dis. 2011; 15 (10): 1279. DOI: 10.5588/ijtld.11.0425.
3. van't Hoog A.H., Meme H.K., Laserson K.F. et al. Screening strategies for tuberculosis prevalence surveys: the value of chest radiography and symptoms. PLoS One. 2012; 7 (7): e38691. DOI: 10.1371/journal.pone.0038691.
4. Nakiyingi L., Bwanika J. M., Kirenga B. et al. Clinical predictors and accuracy of empiric tuberculosis treatment among sputum smear–negative HIV-infected adult TB suspects in Uganda. PLoS One. 2013; 8 (9): e74023.
5. Perlman D.C., el-Sadr W.M., Nelson E.T. et al. Variation of chest radiographic patterns in pulmonary tuberculosis by degree of human immunodeficiency virus-related immunosupression. The Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA). The AIDS Clinical Trials Group (ACTG). Clin. Infect. Dis. 1997; 25 (2): 242–246.
6. Santos Neto M., da Silva F.L., de Sousa K.R. et al. Clinical and epidemiological profile and prevalence of tuberculosis/HIV co-infection in a regional health district in the state of Maranhão, Brazil. J. Bras. Pneumol. 2012; 38 (6): 724–732. DOI: 10.1590/S1806–37132012000600007.
7. Kouassi B., N'gom A., Horo K. et al. Correlation of the manifestations of tuberculosis and the degree of immunosuppression in patients with HIV. Rev. Mal. Respir. 2013; 30 (7): 549–554. DOI: 10.1016/j.rmr.2013.01.003.
8. Padyana M., Bhat R.V., Dinesha M., Nawaz A. HIV-Tuberculosis: A study of chest X-Ray patterns in relation to CD4 count. N. Am. J. Med. Sci. 2012; 4 (5): 221–225. DOI: 10.4103/1947–2714.95904.
9. Maniar J.K., Kamath R.R., Mandalia S. et al. HIV and tuberculosis: Partners in crime. Indian J. Dermatol. Venereol. Leprol. 2006; 72 (4): 276–282. DOI: 10.4103/0378–6323.26723.
10. Besen A., Staub G.J., Silva R.M. Clinical, radiological, and laboratory characteristics in pulmonary tuberculosis patients: comparative study of HIV-positive and HIV-negative inpatients at a referral hospital. J. Bras. Pneumol. 2011: 37 (6): 768–775.
11. Henn L., Nagel F., Dal Pizzol F. Comparison between human immunodeficiency virus positive and negative patients with tuberculosis in Southern Brazil. Mem. Inst. Oswaldo Cruz. 1999; 94 (3): 377–381. DOI: 10.1590/S0074-02761999000300017.
12. da Silva R.M., da Rosa L., Lemos R.N. Radiographic alterations in patients presenting human immunodeficiency virus/tuberculosis coinfection: correlation with CD4+ T cell counts. J. Bras. Pneumol. 2006; 3 2(3): 228–233.
13. Song I., Jeong Y.J., Lee K.S. et al. Tuberculous lymphadenitis of the thorax: comparisons of imaging findings between patients with and those without HIV infection. Am. J. Roentgenol. 2012; 199 (6): 1234–1240. DOI: 10.2214/AJR.12.8522.
14. Picon P.D., Caramori M.L., Bassanesi S.L. et al. Differences in the clinical and radiological presentation of intrathoracic tuberculosis in the presence or absence of HIV infection. J. Bras. Pneumol. 2007; 33 (4): 429–436.
15. Burrill J., Williams C.J., Bain G. et al. Tuberculosis: a radiologic review. Radiographics. 2007; 27 (5): 1255–1273. DOI: 10.1148/rg.275065176.
16. de Albuquerque Mde F., Albuquerque S.C., Campelo A.R. et al. Radiographic features of pulmonary tuberculosis in patients infected by HIV: is there an objective indicator of co-infection? Rev. Soc. Bras. Med. Trop. 2001; 34 (4): 369–372. DOI: 10.1590/S0037-86822001000400010.
17. Tshibwabwa-Tumba E., Mwinga A., Pobee J.O., Zumla A. Radiological features of pulmonary tuberculosis in 963 HIV–infected adults at three Central African Hospitals. Clin. Radiol. 1997; 52 (11): 837–841. DOI: 10.1016/S0009-9260(97)80078-5.
18. Trajman A., Neto E.B., Belo M.T. et al. Pleural tuberculosis and human immunodeficiency virus co-infection. Int. J. Tuberc. Lung Dis. 1997; 1 (6): 498–501.
Review
For citations:
Borovitskiy V.S. Radiographic features of pulmonary tuberculosis in HIV-infected patients with different severity of immunosuppression and deviant behavior. PULMONOLOGIYA. 2018;28(2):211-216. (In Russ.) https://doi.org/10.18093/0869-0189-2018-28-2-211-216
Views:
1603
Email this article 