Comparing Radiological Features of Pulmonary Tuberculosis with and without HIV Infection

Abstract

Objectives: The aim of this study was to determine and compare the radiological appearance of pulmonary tuberculosis (PTB) in groups of patients with and without human immunodeficiency virus (HIV) infection in a main referral center for Infectious disease in Iran. Materials and Methods: One hundred and nineteen six patients with and without HIV infection was referred to infectious disease department of Imam Khomeini hospital. 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 65% were male. The diffuse pulmonary involvement was more common in PTB / HIV confection group than PTB without HIV infection (27.7% vs 12%) Milliary pattern on chest X- ray in PTB / HIV group was more common too (17% vs 4.7%). However, HIV positive patients less commonly had cavitary lesion (4.3% vs 20.1%). The presence of pleural effusion was less common in PTB/ HIV group (13% vs 23.5%) and hilar lymphadenopathy was more common (10.6 vs 7.4%) in this group. Conclusion: This study suggests that the rate of atypical patterns of CXR in PTB patients are growing because of increased frequency of HIV infection as well as IDUs, the main reason for the altered radiographic appearance of PTB may be due to way of selecting patients from a referral centre of infectious disease in country.