A Study on the Radiological Presentation of HIV –Tb Coinfection and Its Correlation with Cd4 Count
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 5
Abstract
Objectives: The aim of this study was to determine and compare the radiological appearance of pulmonary tuberculosis (PTB) and its correlation with CD4 count in groups of patients with and without human immunodeficiency virus (HIV) infection in ART & CHEST clinic in kilpauk Medical College Hospital, Chennai, Tamilnadu, Chennai. Materials and Methods: A total number of 60 patients of HIV + ve TB and 30 patients HIV –veTB were enrolled in this study. The diagnosis of PTB was made on the basis of clinical history, physical examination, Ziehl-Neelsen microscopy on three sputum samples and chest radiography. The following issues were recorded for each radiograph: the number of zones involved with consolidation, cavitation, pleural effusion, bronchopulmonary pattern of spread; milliary disease; hilar and mediastinal lymphadenopathy. Results: Out of all participant males are commonly infected (68%). The diffuse pulmonary involvement was more common in PTB / HIV confection group than PTB without HIV infection (27.7% vs 12%). Medistinal lymphadenopathy and lower zone infiltration are common on chest X- ray in PTB / HIV group than HIV-ve group (35.5% vs 0%). However, HIV positive patients less commonly had cavitary lesion (0% vs 57.69%).. On analyzing the CD4 count with radiological pattern , when the count goes below 200 typical pattern chest x ray findings are more common. When CD4 count more than 200 typical pattern may occur. Conclusion: Atypical chest x-ray findings are common in HIV- TB co infection. The most common atypical presentations are mediastinal adenopathy, lower zone infiltrations and military mottling. Cavitation is rare in HIV-TB co infection. When the CD4 count is more than 200, upper zone infiltration is more common. When the CD4 count less than 200, atypical x ray findings are common. Lymphnodes, meninges and pleura are the common sites of extra pulmonary TB involvement. Tuberculosis can occur at any level of depletions of CD4 count. But when the CD4 count is grossly low extra pulmonary TB is more common. Since TB-HIV fuel each other , early diagnosis And proper effective management are essential to reduce the morbidity and mortality.
Authors and Affiliations
DR. S. Geetha MD. , DR. S. Malathi MD. , DR. V. Madhavan MD, DR. Vijay Usharaj . MD
Keywords
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- EP ID EP598199
- DOI 10.9790/0853-1605121824.
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