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Abdominal findings in AIDS-related pulmonary tuberculosis correlated with associated CD4 levels
A Solomon1, C Feldman, S A Kobilski
1Department of Diagnostic Radiology, University of Witwatersrand, Parktown, South Africa.
Background:
To document the abdominal manifestations of tuberculosis (TB) associated with human immunodeficiency virus (HIV) infection and to correlate those findings with CD4 levels.
Methods:
Twenty-nine HIV-positive patients with culture-proven Mycobacterium tuberculosis infection were entered into the study. Chest changes were used to separate patients into two groups: those with and those without evidence of previous TB. All patients had standard chest radiographs, routine and high-resolution chest computed tomography (CT), and abdominal ultrasound examinations. Twenty-four patients had abdominal CT scans.
Results:
The group of patients with no previous radiographic evidence of pulmonary TB had a significantly greater tendency to have manifestations of pulmonary and/or abdominal miliary dissemination. Those patients with radiological evidence of miliary dissemination were significantly more likely to have CD4 counts of less than 300.
Conclusions:
Chest and abdominal miliary dissemination of TB in HIV-positive patients is significantly associated with radiologically determined primary onset pulmonary TB. These changes occur predominantly at CD4 counts of less than 300.