Hiv-tuberculosis: A study of chest X-ray patterns in relation to CD4 count

Mahesha Padyana, Raghavendra V. Bhat, M. Dinesha, Alam Nawaz

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Fight against human immunodefciency virus (HIV) is incomplete without addressing problems associated with diffcult 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.

Original languageEnglish
Pages (from-to)221-225
Number of pages5
JournalNorth American Journal of Medical Sciences
Volume4
Issue number5
DOIs
Publication statusPublished - 08-05-2012

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CD4 Lymphocyte Count
Tuberculosis
Thorax
X-Rays
Viruses
Pulmonary Tuberculosis
Defective Viruses
Sputum
Tertiary Care Centers
India
Cohort Studies
Prospective Studies
Guidelines
Lung
Incidence

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Padyana, Mahesha ; Bhat, Raghavendra V. ; Dinesha, M. ; Nawaz, Alam. / Hiv-tuberculosis : A study of chest X-ray patterns in relation to CD4 count. In: North American Journal of Medical Sciences. 2012 ; Vol. 4, No. 5. pp. 221-225.
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abstract = "Background: Fight against human immunodefciency virus (HIV) is incomplete without addressing problems associated with diffcult 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.",
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Hiv-tuberculosis : A study of chest X-ray patterns in relation to CD4 count. / Padyana, Mahesha; Bhat, Raghavendra V.; Dinesha, M.; Nawaz, Alam.

In: North American Journal of Medical Sciences, Vol. 4, No. 5, 08.05.2012, p. 221-225.

Research output: Contribution to journalArticle

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N2 - Background: Fight against human immunodefciency virus (HIV) is incomplete without addressing problems associated with diffcult 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.

AB - Background: Fight against human immunodefciency virus (HIV) is incomplete without addressing problems associated with diffcult 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.

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