A Study of Various Chest Radiological Manifestations of Pulmonary Tuberculosis in both Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients in a South Indian Population
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Abstract
Context: The chest radiography is an essential diagnostic tool in assessing the pattern and progression of pulmonary tuberculosis (PTB), which helps in taking suitable clinical decisions.
Aims: The aim of this study is to bring out any specific radiologic pattern in PTB among human immunodeficiency virus (HIV) infected and noninfected and make an attempt to systemize reporting and recording radiographic findings.
Settings and Design: Patients of all age groups with sputum positivity were included in the study and divided into groups based on gender, age and HIV-infected and noninfected patients. Chest radiographs were taken and assessed for findings.
Materials and Methods: Data for the study were taken from sputum acid-fast bacilli positive patient’s referred to the Department of Radiodiagnosis for chest X-ray and were evaluated with standard posterior-anterior chest radiograph.
Statistical Analysis Used: Documented observations were compiled using SPSS-16.5 software (IBM). Univariate analysis was carried
out for data interpretation.
Findings/Results: Chest radiographic pattern change between HIV and noninfected cases. Lymphadenopathy was more common in patients with low CD4 count, predominantly involving the right hilar and mediastinal nodes. Large opacities with mid zone predilection, smaller opacities involving both upper zones, and bilateral lung involvement in patients with HIV coinfection was indicative of low CD4 count.
Conclusions: In the present study, it was observed that major chest radiographic pattern change between patients with HIV and noninfected cases were increase in large opacities, decrease in cavity formation, increase in pleural effusion, no apical cap, and no volume loss. Lymphadenopathy was more common in patients with low CD4+ count (<200 cells/dl).
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