Radiographic features of pulmonary tuberculosis in HIV-infected patients with different severity of immunosuppression and deviant behavior

Abstract

The objective of this study was to investigate radiological features of pulmonary tuberculosis in HIV-infected patients with different severity of immunosuppression and deviant behavior. Methods. This was a single-center total observational retrospective study. The study involved 257 patients with pulmonary tuberculosis and NIV-infection who was treated and followed at a penitentiary tuberculosis hospital. Results. Tuberculosis-associated lung lesions were diagnosed in 94.2% of patients. Extrapulmonary and generalized tuberculosis increased with worsening immunity. Majority of patients were 20 – 29 and 30 – 39 years old. Typical radiological features included lung root lesions due to hilar lymph node enlargement in patients with CD4 lymphocytes < 100 cells/µL. CD4 lymphocytes decrease < 100 cells/µL was more likely in patients with involvement of ≥ 3 lung lobes and less likely in patients with involvement of 1 or 2 lung segments. CD4 lymphocytes decrease < 100 cells/µL was associated with prominent lung tissue infiltration (39.0%); moderate infiltration of the lung tissue did not depend on immunosuppression. Cavitation ≤ 2 cm was frequent (76.9 – 96.0%), mostly in the right lung (36.4 – 53.8%) and did not depend on immunosuppression. Conclusion. The most prevalent pulmonary tuberculosis in HIV-infected patients was infiltrative tuberculosis independently on CD4 lymphocyte number.