Clinical and radiographic features of HIV-related pulmonary tuberculosis according to the level of immunosuppression Características clínicas e radiológicas da tuberculose pulmonar associada ao HIV de acordo com o nível de imunossupressão

Medical charts and radiographs from 38 HIV-infected patients with positive cultures for Mycobacterium tuberculosis from sputum or bronchoalveolar lavage were reviewed in order to compare the clinical, radiographic, and sputum bacilloscopy characteristics of HIV-infected patients with pulmonary tuber...

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Bibliographic Details
Published in:Revista da Sociedade Brasileira de Medicina Tropical 2007-12, Vol.40 (6), p.622-626
Main Authors: Guilherme Freire Garcia, Alexandre Sampaio Moura, Cid Sérgio Ferreira, Manoel Otávio da Costa Rocha
Format: Article
Language:English
Subjects:
Acquired immunodeficiency syndrome
CD4 lymphocyte count
Contagem de linfócito CD4
Pulmonary tuberculosis
Radiografia torácica
Síndrome da imunodeficiência adquirida
Thoracic radiography
Tuberculose pulmonar
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Summary:Medical charts and radiographs from 38 HIV-infected patients with positive cultures for Mycobacterium tuberculosis from sputum or bronchoalveolar lavage were reviewed in order to compare the clinical, radiographic, and sputum bacilloscopy characteristics of HIV-infected patients with pulmonary tuberculosis according to CD4+ lymphocyte count (CD4). The mean age of the patients was 32 years and 76% were male. The median CD4 was 106 cells/mm³ and 71% had CD4 < 200 cells/mm³. Sputum bacilloscopy was positive in 45% of the patients. Patients with CD4 < 200 cells/mm³ showed significantly less post-primary pattern (7% vs. 63%; p = 0.02) and more frequently reported weight loss (p = 0.04). Although not statistically significant, patients with lower CD4 showed lower positivity of sputum bacilloscopy (37% vs. 64%; p = 0.18). HIV-infected patients with culture-confirmed pulmonary tuberculosis had a high proportion of non-post-primary pattern in thoracic radiographs. Patients with CD4 lower than 200 cells/mm³ showed post-primary patterns less frequently and reported weight loss more frequently.Foram revisados prontuários e radiografias de 38 pacientes infectados pelo HIV com culturas de escarro ou lavado broncoalveolar positivas para Mycobacterium tuberculosis no intuito de comparar características clínicas, radiológicas e baciloscópicas de pacientes HIV-positivos com tuberculose pulmonar de acordo com a contagem de linfócitos CD4. A idade média dos pacientes foi 32 anos e 76% eram homens. Mediana de CD4 foi 106 cells/mm³ e 71% tinham CD4
ISSN:0037-8682
1678-9849
DOI:10.1590/S0037-86822007000600004