Radiographic features of pulmonary tuberculosis in patients infected by HIV: is there an objective indicator of co-infection?

Albuquerque, Maria de Fátima Militão de; Albuquerque, Sílvio Cavalcanti de; Campelo, Antônio Roberto Leite; Cruz, M. A. Rivero; Souza, Wayner V.; Ximenes, Ricardo A. A.; Souza, Roberta A.S. de

doi:10.1590/s0037-86822001000400010

Cited by 18 publications

(18 citation statements)

References 7 publications

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“…(1, 3,8,13,15,16,20) However, among those that compared HIV-positive and HIV-negative patients, the difference in the frequency of hematogenous TB was significant only in the series with the greatest number of cases studied, (15) which is in accordance with what has been observed in a study conducted in Brazil. (16) Tuberculous pneumonia, despite having had a similar frequency in the HIV-positive and in the HIV-negative patients, was twice as prevalent in the patients with AIDS as in the HIV-negative patients.…”

Section: Discussionsupporting

confidence: 81%

“…(16) Tuberculous pneumonia, despite having had a similar frequency in the HIV-positive and in the HIV-negative patients, was twice as prevalent in the patients with AIDS as in the HIV-negative patients. This type of TB is not typically described cavitation, frequency of multifocal disease, or distribution of the types of TB.…”

Section: Discussionmentioning

confidence: 96%

“…(2)(3)(4)(5)11,(13)(14)(15)(16) In studies in which the differences between the two groups were not significant, this may have occurred due to the lower level of immunosuppression of the HIV-patients included or to the lower prevalence of co-infection in the population studied. (11,16) The high frequencies of lymph node enlargement in HIV-negative patients found in some studies, and which are higher than those observed in the present study, (3)(4)(5)15) can be explained by the occurrence of primary TB in countries of low TB prevalence or by racial factors, since lymph node enlargement is more common in Blacks, which could explain the higher rates found in some studies conducted in Africa and in Haiti. (3)(4)(5)15) In the present study, the HIV-patients with lymph node enlargement and pulmonary lesions had lower CD4 counts than did those with pulmonary lesions only -47 cells/mm 3 27 of whom (23.9%) were HIV-positive, and 3 of whom (2.5%) were HIV-negative (p < 0.0001).…”

Section: Discussionmentioning

confidence: 99%

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Diferenças na apresentação clínico-radiológica da tuberculose intratorácica segundo a presença ou não de infecção por HIV

et al. 2007

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Objective: To describe the differences in the clinical and radiological presentation of tuberculosis in the presence or absence of HIV infection. Methods: A sample of 231 consecutive adults with active pulmonary tuberculosis admitted to a tuberculosis hospital were studied, assessing HIV infection, AIDS, and associated factors, as well as re-evaluating chest X-rays. Results: There were 113 HIV-positive patients (49%) Comparing the 113 HIV-positive patients (49%) to the 118 HIV-negative patients (51%), the former presented a higher frequency of atypical pulmonary tuberculosis (pulmonary lesions accompanied by intrathoracic lymph node enlargement), hematogenous tuberculosis, and pulmonary tuberculosis accompanied by superficial lymph node enlargement, as well as presenting less pulmonary cavitation. The same was found when HIV-positive patients with AIDS were compared to those without AIDS. There were no differences between the HIV-positive patients without AIDS and the HIV-negative patients. Median CD4 counts were lower in HIV-positive patients with intrathoracic lymph node enlargement and pulmonary lesions than in the HIV-positive patients with pulmonary lesions only (47 vs. tive sputum smear microscopy; having undergone HIV testing; and having undergone simple anteroposterior and lateral chest X-ray.The data were obtained through the re-evaluation of chest X-rays and the review of medical charts. The variables analyzed were as follows: age; gender; alcoholism; use of illicit drugs; corticosteroid use; duration of symptoms; presence of multifocal disease, diabetes mellitus, neoplasias, and opportunistic diseases; results of HIV testing; number of CD4 T lymphocytes; and radiological findings.Sputum smear microscopy was performed using the Ziehl-Neelsen technique. The HIV testing was performed using the ELISA method, and positive results were confirmed by Western blot. The CD4 counts were obtained using flow cytometry. Alcoholism and drug addiction were considered present when they had been registered on the medical chart by the treatment team. Multifocal disease was defined by the presence of superficial lymph node enlargement in patients with pulmonary TB.The chest X-rays were independently evaluated by two radiologists, who had no knowledge of the results of HIV testing, in order to identify the types of TB; the location of the lesions in the lung segments; and the presence of cavitary lesions, hilar or mediastinal lymph node enlargement, and pleural effusion. In case of inconsistency between the evaluations, the chest X-rays were jointly examined and, in the event of the inconsistency persisting, a third radiologist was consulted so that a consensus could be reached. The types of TB were characterized using the following classification: 1) Classic pulmonary TB: pulmonary lesions unaccompanied by hilar or mediastinal lymph node enlargement; 2) Tuberculous pneumonia: homogeneous consolidation with air bronchograms, with or without intrathoracic lymph node enlargement; 3) Hematogenous TB: diffuse pulmonar...

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Diferenças na apresentação clínico-radiológica da tuberculose intratorácica segundo a presença ou não de infecção por HIV

et al. 2007

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“…In sub-Saharan Africa, the HIV epidemic has contributed to the spread of M. tuberculosis disease frequently associated with an atypical clinical presentation (de Albuquerque et al, 2001). The high HIV seroprevalence accompanied by the often undiagnosed TB disease in these countries contribute to diagnostic and treatment delays.…”

Section: Otn-pcr Analysis Of Urinementioning

confidence: 99%

PCR-based detection of the Mycobacterium tuberculosis complex in urine of HIV-infected and uninfected pulmonary and extrapulmonary tuberculosis patients in Burkina Faso

Torrea

2005

Journal of Medical Microbiology

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To evaluate a one-tube nested PCR-based analysis of urine for diagnosing pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) in Bobo-Dioulasso, Burkina Faso, a prospective analysis of urine samples from HIV-and non-HIV-infected adults with PTB and EPTB (case patients) and with pathology other than tuberculosis (TB) (control patients) was performed. Three groups of patients were classified as microbiological-positive and -negative PTB and EPTB on the basis of clinical signs and microbiological results. Urine from patients was analysed using the DNA extraction and Sechi's methods, both modified, for the detection of Mycobacterium tuberculosis. The sensitivity, specificity, positive predictive value and negative predictive value were calculated. The sensitivity of the test for the microbiological-positive PTB, microbiological-negative PTB and EPTB was 40 . 5 % (88/217), 66 . 7 % (20/30) and 57 . 1 % (48/84), respectively. The specificity was 98 . 2 %. Differences were observed in the two populations infected and not infected by HIV. This method is not appropriate for detection of new TB cases in the routine laboratory, but it can be useful for cases where the clinical and bacteriological diagnosis of TB is not conclusive.

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“…3 However, the number of TB cases is increasing worldwide, and the HIV pandemic is considered to be one of its major causes. 4,5 In developed countries an increase in cases was due to coinfection with HIV, and paradoxically, the increase in longevity with the emergence of TB in the elderly. These groups have accumulated and caused cohabiting institutional outbreaks.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the effectiveness of a home-based care program for patients coinfected with tuberculosis and human immunodeficiency virus after discharge from a reference hospital in South-Eastern Brazil

Bento¹,

Pedroso²

2010

Braz J Infect Dis

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We declare no confl ict of interest. ABSTRACTThe effectiveness of tuberculosis treatment delivered by a home-based care program to patients coinfected with HIV was compared with that of a service provided by outpatient departments. A retrospective study was made of a cohort of coinfected patients discharged from hospital between January 1998 and December 2002 who had been followed-up for one year within one of these programs. Two-hundred-and-forty-three patients who met the inclusion criteria were grouped according to their treatment program (group 1 received home-based care; group 2 attended outpatient departments) and then paired one-to-one across the groups by gender, age and level of education. Only 48 patients from each group could be paired. Apart from the duration of HIV infection, there were no statistically signifi cant differences (P < 0.05) between patients in the two groups with respect to social-demographic status and clinical or laboratory characteristics. In group 1, 75.0% of patients attained successful tuberculosis treatment compared with 72.9% of those in group 2 (P = 0.816). Treatment was abandoned by 22.9% of patients in group 1 and by 54.2% of those in group 2 (P = 0.008). The death rate within one year after discharge was 20.8% for group 1 compared with 6.3% for group 2 (P = 0.334). Although both programs achieved a similar success rate in the treatment of tuberculosis, patients receiving outpatient care were three to eight-times more likely to abandon the program. The importance of assigning patients at-risk of abandoning treatment to a home-based care program after discharge from hospital is emphasized.

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Radiographic features of pulmonary tuberculosis in patients infected by HIV: is there an objective indicator of co-infection?

Abstract: This study aimed to compare the radiographic characteristics of patients with pulmonary tuberculosis (TB) and human immunodeficiency virus (HIV) infection with those of HIV-negative patients. In all, 275 TB patients attending the outpatients clinics at the University

Cited by 18 publications

References 7 publications

Diferenças na apresentação clínico-radiológica da tuberculose intratorácica segundo a presença ou não de infecção por HIV

Diferenças na apresentação clínico-radiológica da tuberculose intratorácica segundo a presença ou não de infecção por HIV

PCR-based detection of the Mycobacterium tuberculosis complex in urine of HIV-infected and uninfected pulmonary and extrapulmonary tuberculosis patients in Burkina Faso

Assessment of the effectiveness of a home-based care program for patients coinfected with tuberculosis and human immunodeficiency virus after discharge from a reference hospital in South-Eastern Brazil

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