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Processing of Bronchoalveolar Lavage Fluid and Matched Blood for Alveolar Macrophage and CD4+ T-cell Immunophenotyping and HIV Reservoir Assessment
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Cavitary pulmonary tuberculosis HIV-related

Elisa Busi Rizzi1, Vincenzo Schininà, Fabrizio Palmieri

  • 1Department of Radiology, National Institute for Infectious Diseases, Lazzaro Spallanzani, Servizio di Radiologia, Via Portuense 292, 00149 Roma, Italy. radiologia@inmi.it <radiologia@inmi.it>

European Journal of Radiology
|October 19, 2004
PubMed
Abstract

Insights

Pulmonary tuberculosis (TB) in HIV-positive patients often shows typical primary TB radiographic patterns, not atypical reactivation. This suggests HIV-related TB appearances are consistent with the general population.

Area of Science:

  • Radiology
  • Infectious Diseases
  • Immunology

Background:

  • Pulmonary tuberculosis (TB) in HIV-seropositive patients was often presumed to be reactivation TB.
  • Radiographic features in these patients were frequently considered atypical, resembling recent disease.
  • This study hypothesizes that "atypical" features represent a higher proportion of primary TB, typical for this pattern.

Purpose of the Study:

  • To investigate the radiological patterns of pulmonary tuberculosis in HIV-seropositive patients.
  • To determine if observed radiographic features are typical of primary TB rather than reactivation TB.

Main Methods:

  • Retrospective review of chest imaging for 219 HIV-positive patients with confirmed pulmonary TB.
  • Assessment of cavitation, parenchymal abnormalities, adenopathies, and pleural effusion.
  • Classification of radiological patterns as primary or post-primary TB.

Main Results:

  • 50% of patients exhibited a post-primary TB pattern.
  • The rate of cavitation was 63%, comparable to the general population.
  • Cavitation rates were similar across CD4 counts (<200 or >200 cells/mm³).

Conclusions:

  • HIV-related pulmonary tuberculosis demonstrates typical radiological appearances, consistent with the general population.
  • Molecular epidemiological techniques can definitively classify TB episodes as primary or post-primary.

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