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Radiographic findings in HIV-positive patients with sensitive and resistant tuberculosis
K D Lessnau1, M Gorla, W Talavera
1Cabrini Medical Center, New York 10003.
Chest
|September 1, 1994
Summary
Early chest X-ray changes can help identify multi-drug resistant tuberculosis (MDR-TB) in HIV-positive patients. Deterioration after two weeks of therapy suggests MDR-TB, prompting treatment adjustments.
Area of Science:
- Pulmonology
- Infectious Diseases
- Radiology
Background:
- Multi-drug resistant tuberculosis (MDR-TB) poses a significant challenge, especially in HIV-positive individuals.
- Early diagnosis is crucial for effective treatment and preventing disease progression.
Purpose of the Study:
- To evaluate chest X-ray findings for early recognition of MDR-TB in HIV-positive patients.
- To correlate radiographic features with drug sensitivities and clinical outcomes.
Main Methods:
- Retrospective review of chest X-rays from 72 HIV-positive patients with tuberculosis (TB).
- Correlation of radiographic findings with drug sensitivity testing, clinical data, and treatment response.
- Analysis of changes in radiographic patterns after two weeks of antituberculosis therapy.
Main Results:
- No significant initial radiographic differences were observed between sensitive, single-drug resistant (SDR), and MDR-TB groups.
- Development of new effusions, lymphadenopathy, or worsening infiltrates after two weeks of therapy was associated with MDR-TB (95% probability).
- Normal chest X-rays were observed in 10% of patients.
Conclusions:
- Chest X-ray findings alone are not sufficient for initial differentiation of TB drug resistance in HIV-positive patients.
- Radiographic deterioration after two weeks of therapy strongly suggests MDR-TB.
- Adjusting antituberculosis therapy based on clinical and radiographic deterioration is recommended for HIV-positive patients.