Chest Radiograhic Patterns of Smear Positive Tuberculosis in Relation to HIV: A Cross-Sectional Study in a Population with a High Burden of HIV and Tuberculosis.

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Date
2014-12-11
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Abstract
Aim: The purpose of this study was to investigate the chest radiographic patterns of smear positive pulmonary tuberculosis patients in relation to HIV co-infection. Study Deign: Cross-sectional descriptive study Place and Duration of the Study: The study was conducted at Gondar University hospital between May 2004–December 2007. Methodology: We studied chest radiographs of 207 (128 HIV negative and 79 HIV positive) consecutive sputum smear positive pulmonary tuberculosis patients according to the standard classification. Mean and percentages/ proportions were used for descriptive analysis. Chi square test was used to measure association. Results: The prevalence of HIV in patients with smear positive pulmonary tuberculosis was 38.2%. The most common chest radiographic patterns were fibronodular (83.1%), cavity (60.4%), lobar consolidation (49.8%), and brochopnemonic consolidation (9.2%). Lymphadenopthy and pleural effusion were more common in HIV co infected patients (p<0.01). Cavities, upper lobe disease and increased mean number of lung lobes involved were more prominent in HIV negative patients (P<0.05). Despite a higher rate of patients with far advanced CXR patterns in HIV negative TBC patients compared to HIV positive (p<0.026), there was no significant difference in the radiographic, sputum smear conversion or clinical response in terms of increased body mass index after 8 weeks of anti TBC treatment between HIV negative and HIV positive patients. Conclusion: Post primary pulmonary tuberculosis was the commonest chest radiographic pattern at presentation in both HIV positive and HIV negative patients, but atypical chest radiographic presentations were associated with co-infection. It was more common for HIV negative tuberculosis patients to have a radiologically far advanced pattern which did not correspond to the clinical and radiological response. This may prompt a need for revision of the current radiological classification.
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Pulmonary tuberculosis, sputum smear positive tuberculosis, chest radiography, HIV co infection
Citation
Getachew Assefa, Idh Jonna, Sillasie Samuel G, Schön Thomas.Chest Radiograhic Patterns of Smear Positive Tuberculosis in Relation to HIV: A Cross-Sectional Study in a Population with a High Burden of HIV and Tuberculosis. British Journal of Medicine and Medical Research. 2014 Dec; 4(35): 5474-5483.