TY - JOUR
T1 - Differences in the clinical and radiological presentation of intrathoracic tuberculosis in the presence or absence of HIV infection
AU - Picon, Pedro Dornelles
AU - Caramori, Maria Luiza Avancini
AU - Bassanesi, Sérgio Luiz
AU - Jungblut, Sandra
AU - Folgierini, Marcelo
AU - Da Silva Porto, Nelson
AU - Rizzon, Carlos Fernando Carvalho
AU - Ferreira, Roberto Luiz Targa
AU - De Freitas, Tânia Mariza
AU - Jarczewski, Carla Adriane
PY - 2007
Y1 - 2007
N2 - Objective: To describe the differences in the clinical and radiological presentation of tuberculosis in the presence or absence of HlV infection. Methods: A sample of 231 consecutive adults with active pulmonary tuberculosis admitted to a tuberculosis hospital were studied, assessing HIV infection, AIDS, and associated factors, as well as re-evaluating chest X-rays. Results: There were 113 HIV-positive patients (49%) Comparing the 113 HIV-positive patients (49%) to the 118 HIV-negative patients (51%), the former presented a higher frequency of atypical pulmonary tuberculosis (pulmonary lesions accompanied by intrathoracic lymph node enlargement), hematogenous tuberculosis, and pulmonary tuberculosis accompanied by superficial lymph node enlargement, as well as presenting less pulmonary cavitation. The same was found when HIV-positive patients with AIDS were compared to those without AIDS. There were no differences between the HIV-positive patients without AIDS and the HIV-negative patients. Median CD4 counts were lower in HIV-positive patients with intrathoracic lymph node enlargement and pulmonary lesions than in the HIV-positive patients with pulmonary lesions only (47 vs. 266 cells/mm 3; p < 0.0001), in HIV-positive patients with AIDS than in those without AIDS (136 vs. 398 cells/mm3; p < 0.0001) and in patients with atypical pulmonary tuberculosis than in those with other fonns of tuberculosis (31 vs. 258 cells/mm3; p < 0.01). Conclusion: Atypical forms and disseminated disease predominate among patients with advanced immunosuppression. In regions where TB prevalence is high, the presence of atypical pulmonary tuberculosis or pulmonary tuberculosis accompanied by superficial lymph node enlargement should be considered an AlDSdefining condition.
AB - Objective: To describe the differences in the clinical and radiological presentation of tuberculosis in the presence or absence of HlV infection. Methods: A sample of 231 consecutive adults with active pulmonary tuberculosis admitted to a tuberculosis hospital were studied, assessing HIV infection, AIDS, and associated factors, as well as re-evaluating chest X-rays. Results: There were 113 HIV-positive patients (49%) Comparing the 113 HIV-positive patients (49%) to the 118 HIV-negative patients (51%), the former presented a higher frequency of atypical pulmonary tuberculosis (pulmonary lesions accompanied by intrathoracic lymph node enlargement), hematogenous tuberculosis, and pulmonary tuberculosis accompanied by superficial lymph node enlargement, as well as presenting less pulmonary cavitation. The same was found when HIV-positive patients with AIDS were compared to those without AIDS. There were no differences between the HIV-positive patients without AIDS and the HIV-negative patients. Median CD4 counts were lower in HIV-positive patients with intrathoracic lymph node enlargement and pulmonary lesions than in the HIV-positive patients with pulmonary lesions only (47 vs. 266 cells/mm 3; p < 0.0001), in HIV-positive patients with AIDS than in those without AIDS (136 vs. 398 cells/mm3; p < 0.0001) and in patients with atypical pulmonary tuberculosis than in those with other fonns of tuberculosis (31 vs. 258 cells/mm3; p < 0.01). Conclusion: Atypical forms and disseminated disease predominate among patients with advanced immunosuppression. In regions where TB prevalence is high, the presence of atypical pulmonary tuberculosis or pulmonary tuberculosis accompanied by superficial lymph node enlargement should be considered an AlDSdefining condition.
KW - HIV infections
KW - Pulmonary
KW - Radiography
KW - Thoracic
KW - Tuberculosis
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U2 - 10.1590/s1806-37132007000400012
DO - 10.1590/s1806-37132007000400012
M3 - Article
C2 - 17982535
AN - SCOPUS:40649104367
SN - 1806-3713
VL - 33
SP - 429
EP - 436
JO - Jornal Brasileiro de Pneumologia
JF - Jornal Brasileiro de Pneumologia
IS - 4
ER -