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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
Summary
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.