Particularities of radiological lesions in smear-positive and HIV-positive tuberculosis patients in the era of triple antiretroviral therapy at Jamot Yaoundé hospital

Abstract

Introduction: The aim of this work was to compare the radiological lesions during bacilliferous tuberculosis between HIV positive patients under ARV treatment and HIV negative patients. Methodology: This was a, descriptive and comparative study conducted from December 1, 2018 to May 31, 2019 (6 months) at Jamot Yaoundé Hospital. Smearpositive tuberculosis patients meeting our inclusion criteria were enrolled in the study. We split them into two groups, HIV + and HIV -. The comparison of the data was made by the Chi² test, that of the quantitative data with the Student's T test. A p-value less than 0.05 was considered significant. Results: In total, we recruited 145 patients divided into 2 groups of 63 HIV + patients and 82 HIV-patients. The radiological peculiarities found in HIV were as follows: Normal radiography was more frequent, P = 0.004. Interstitial syndrome was less common. Bilateral involvement was predominant. Right localization and upper lobe lesions were less frequent, P <0.05. Micronodular lesions were more frequent, P <0.05. During the alveolar syndrome, the left side was less affected and the upper lobe was the most; p <0.05. Cavitary, pleural, mediastinal and bronchial syndromes did not show statistically significant differences. Conclusion: Although a normal x-ray does not exclude pulmonary tuberculosis, the x-ray lesions are multiple but are dominated by the interstitial syndrome. In patients immunocompromised to HIV, bilateral involvement predominates. The right localization and lesions of the upper lobe are less frequent. Micronodular lesions are frequent.