Radiographic Manifestations in TB/ HIV Patients


1 Department of Radiology,

2 Department of Infectious Diseases

3 Department of Radiology

4 Department of Pulmonary Medicine

5 Department of Pediatrics, NRITLD, Shaheed Beheshti University of Medical Sciences and Health Services, THERAN-IRAN.


Background: HIV is the most common risk factor for reactivation of latent TB and is associated with increased rate of progression of infection to disease. Radiological presentation of TB is variable in both HIV (-) and HIV (+) patients but is more in the latter. In this study we describe and analyze radiological presentation of TB/HIV patients in Massih Daneshvari hospital in IRAN. Materials and Methods: We registered the demographic, clinical and laboratory information of TB/HIV patients in MassihDaneshvari hospital between 2002-2003. Inclusion criteria were standard serologic test for HIV (Two positive Elisa test and one positive westernblot test) and proof of TB with clinical and mycobacteriologic or pathologic criteria. Chest x-ray was reported by pulmonary imaging specialist and was divided to two category: Typical (fibrocavitary infiltration in posteroapical segment of upper lobes) and atypical (opacity in middle and lower lobe, hilar and mediastinal adenopathy, pleural effusion, diffuse nodular opacity and normal X-ray). Findings were analyzed using SPSS version 10.5. Results: 15 patients, 13 men (86.7%) and 2 women were included. Mean (±SD) of CD4 count was 229.15 ± 199.45. 53.3% of patients had adenopathy, 26.7% had pleural effusion. Only one patient had cavitary disease. Radiographic pattern was typical in one (6.7%) and atypical in 93.3% of patients. In regard to severity of radiological presentation, mild; moderate and severe pattern was seen in 40%, 26.7% and 33.3% respectively. There was no correlation between severity of radiological presentation and death (p=0.8) and severity of radiological presentation and CD4 count (p=0.53). Conclusion: In this study, it was shown that in spite of some other studies, radiological presentation had not direct correlation with CD4 count; thus, in HIV+ patient, we must consider TB in all atypical radiological presentation regardless of CD4 count. (Tanaffos 2004; 3(9): 33-39)