Clinical and chest radiographic features of tuberculosis associated with human immunodeficiency virus in Zimbabwe

In the developing world, the diagnosis of tuberculosis is dependent on clinical and radiologic features as culture facilities are not readily available. It has been reported that tuberculosis in HIV-positive persons can present with atypical clinical and radiographic features. The object of this study was to examine how often atypical features occur in HIV-positive compared with HIV-negative persons and how these findings correspond to sputum-smear findings. Detailed demographic, clinical, and chest radiographic features of tuberculosis were assessed in 202 HIV-positive adults and 220 HIV-negative patients admitted consecutively. Using univariate analysis, several of these features were found to be significantly associated with being HIV-positive, but after multiple regression analysis only, age group (15 to 42 yr), a negative tuberculin response, intrathoracic lymphadenopathy, and lack of cavitation but not sputum-smear status remained significant.