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1996-02-27
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Document 0455
DOCN M9630455
TI Radiologic manifestations of pulmonary tuberculosis in HIV-1 and
HIV-2-infected patients in Abidjan, Cote d'Ivoire.
DT 9603
AU Abouya L; Coulibaly IM; Coulibaly D; Kassim S; Ackah A; Greenberg AE;
Wiktor SZ; De Cock KM; Project RETRO-CI, Abidjan, Cote d'Ivoire.
SO Tuber Lung Dis. 1995 Oct;76(5):436-40. Unique Identifier : AIDSLINE
MED/96091569
AB OBJECTIVES: To compare the radiologic manifestations of pulmonary
tuberculosis in HIV-1-infected, HIV-2-infected, and HIV-negative
patients; and to assess the impact of HIV-related immunosuppression on
the radiologic manifestations of pulmonary tuberculosis. METHODS: We
compared chest radiographs from consecutive HIV-1-positive,
HIV-2-positive and seronegative patients with pulmonary tuberculosis.
Differentiation between HIV-1 and HIV-2 antibodies was based on a
synthetic peptide-based enzyme immunoassay. A subset of patients had
CD4+ lymphocyte levels estimated by flow cytometry; in these patients,
abnormalities on chest radiographs were analysed in relation to the
severity of CD4+ lymphocyte depletion. RESULTS: HIV-1-infected patients
were significantly more likely to have extrapulmonary tuberculosis than
were HIV-2-infected or HIV-negative patients (20% vs 8% and 9%). Among
patients with pulmonary tuberculosis, no differences were observed in
the rates of specific abnormalities on chest radiographs between HIV-1-
and HIV-2-infected patients; both HIV-1- and HIV-2-infected patients had
a higher frequency of pleural effusion than did HIV-negative patients
(8% and 9% vs 4%). Among HIV-infected patients with CD4+ counts of > or
= 400/mm3, 200-399/mm3, and < 200/mm3, respectively, the proportions
with non-cavitary infiltrates and hilar adenopathy increased
significantly (33% to 44% to 58%, and 0% to 14% to 20%), while the
proportion with cavitary lesions decreased significantly (63% to 44% to
29%). CONCLUSIONS: The radiologic manifestations of pulmonary
tuberculosis in HIV-infected patients varied significantly over the
spectrum of immune deficiency. HIV-infected patients with tuberculosis
and relatively high CD4+ counts showed only slight differences from
HIV-negative persons. HIV-1-positive patients had a higher frequency of
extrapulmonary tuberculosis at presentation than those infected with
HIV-2. Radiographic abnormalities were broadly similar in HIV-2-infected
and HIV-1-infected patients. Clinicians and radiologists must be alert
to the altered radiologic spectrum of pulmonary tuberculosis in
immunosuppressed HIV-infected patients.
DE Adult CD4 Lymphocyte Count Female Human HIV
Infections/COMPLICATIONS/IMMUNOLOGY/*RADIOGRAPHY *HIV-1 *HIV-2
Lung/RADIOGRAPHY Male Tuberculosis,
Pulmonary/COMPLICATIONS/IMMUNOLOGY/*RADIOGRAPHY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).