Tuberculosis in HIV positive patients in south africa: A comparative radiological study with HIV negative patients

doi:10.1016/S0009-9260(05)80684-1

Clinical Radiology

Volume 46, Issue 6, December 1992, Pages 387-390

https://doi.org/10.1016/S0009-9260(05)80684-1 Get rights and content

The radiological appearances of active tuberculosis in human immunodeficiency virus (HIV) positive patients was reviewed. A study group of 61 Black HIV positive patients and a control group of 50 Black HIV negative patients were analysed.

The chest radiographs of the HIV seropositive group showed a significantly higher percentage of lymphadenopathy (50%), pleural effusions (38%) and miliary (8%) or interstitial patterns (11%), as compared with those in the seronegative group (8%, 20%, 0% and 4% respectively). Cavitation (38%) and atelectasis (31%) were less common in the seropositive group than in the seronegative group (82% in each category).

Thus in an endemic TB environment an awareness of this difference in appearances will allow the radiologist to alert the referring clinician to the possibility of concomitant HIV seropositivity.

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Citation Excerpt :
These differences can be attributed to varying prevalence of TB among the general population,12 or, as pleural fluid (PF) culture is generally negative, the incidence of TBPE is perhaps underestimated.13 TBPE is more common in men (63.5%),8 in patients aged 15–44 years (61.2%)7, and in HIV-positive patients.8,10,11 Although a higher incidence might be expected in immunocompetent patients than in those with cell-mediated immunity disorders, this is generally not the case.10,11,14,15
Tuberculous pleural effusion (TBPE) is the most common form of extrapulmonary tuberculosis (TB) in Spain, and is one of the most frequent causes of pleural effusion. Although the incidence has steadily declined (4.8 cases/100 000 population in 2009), the percentage of TBPE remains steady with respect to the total number of TB cases (14.3%–19.3%). Almost two thirds are men, more than 60% are aged between 15 and 44 years, and it is more common in patients with human immunodeficiency virus. The pathogenesis is usually a delayed hypersensitivity reaction. Symptoms vary depending on the population (more acute in young people and more prolonged in the elderly). The effusion is almost invariably a unilateral exudate (according to Light's criteria), more often on the right side, and the tuberculin test is negative in one third of cases.
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Original PaperTuberculosis in HIV positive patients in south africa: A comparative radiological study with HIV negative patients

Lancet

Chest

Aids and tuberculosis

British Medical Journal

AIDS commentary. Tuberculosis and human immunodeficiency virus infection

Journal of Infectious Diseases

Tuberculosis in patients with human immunodeficiency virus infection. Review article

New England Journal of Medicine

The radiographic appearance of tuberculosis in patients with the acquired immunodeficiency syndrome (AIDS) and pre-AIDS

American Review of Respiratory Disease

Tuberculosis as a manifestation of the acquired immunodeficiency syndrome (AIDS)

Journal of the American Medical Association

Tuberculosis in patients with the acquired immunodeficiency syndrome

American Review of Respiratory Disease

Original Paper
Tuberculosis in HIV positive patients in south africa: A comparative radiological study with HIV negative patients