       Document 0455
 DOCN  M9630455
 TI    Radiologic manifestations of pulmonary tuberculosis in HIV-1 and
       HIV-2-infected patients in Abidjan, Cote d'Ivoire.
 DT    9603
 AU    Abouya L; Coulibaly IM; Coulibaly D; Kassim S; Ackah A; Greenberg AE;
       Wiktor SZ; De Cock KM; Project RETRO-CI, Abidjan, Cote d'Ivoire.
 SO    Tuber Lung Dis. 1995 Oct;76(5):436-40. Unique Identifier : AIDSLINE
       MED/96091569
 AB    OBJECTIVES: To compare the radiologic manifestations of pulmonary
       tuberculosis in HIV-1-infected, HIV-2-infected, and HIV-negative
       patients; and to assess the impact of HIV-related immunosuppression on
       the radiologic manifestations of pulmonary tuberculosis. METHODS: We
       compared chest radiographs from consecutive HIV-1-positive,
       HIV-2-positive and seronegative patients with pulmonary tuberculosis.
       Differentiation between HIV-1 and HIV-2 antibodies was based on a
       synthetic peptide-based enzyme immunoassay. A subset of patients had
       CD4+ lymphocyte levels estimated by flow cytometry; in these patients,
       abnormalities on chest radiographs were analysed in relation to the
       severity of CD4+ lymphocyte depletion. RESULTS: HIV-1-infected patients
       were significantly more likely to have extrapulmonary tuberculosis than
       were HIV-2-infected or HIV-negative patients (20% vs 8% and 9%). Among
       patients with pulmonary tuberculosis, no differences were observed in
       the rates of specific abnormalities on chest radiographs between HIV-1-
       and HIV-2-infected patients; both HIV-1- and HIV-2-infected patients had
       a higher frequency of pleural effusion than did HIV-negative patients
       (8% and 9% vs 4%). Among HIV-infected patients with CD4+ counts of > or
       = 400/mm3, 200-399/mm3, and < 200/mm3, respectively, the proportions
       with non-cavitary infiltrates and hilar adenopathy increased
       significantly (33% to 44% to 58%, and 0% to 14% to 20%), while the
       proportion with cavitary lesions decreased significantly (63% to 44% to
       29%). CONCLUSIONS: The radiologic manifestations of pulmonary
       tuberculosis in HIV-infected patients varied significantly over the
       spectrum of immune deficiency. HIV-infected patients with tuberculosis
       and relatively high CD4+ counts showed only slight differences from
       HIV-negative persons. HIV-1-positive patients had a higher frequency of
       extrapulmonary tuberculosis at presentation than those infected with
       HIV-2. Radiographic abnormalities were broadly similar in HIV-2-infected
       and HIV-1-infected patients. Clinicians and radiologists must be alert
       to the altered radiologic spectrum of pulmonary tuberculosis in
       immunosuppressed HIV-infected patients.
 DE    Adult  CD4 Lymphocyte Count  Female  Human  HIV
       Infections/COMPLICATIONS/IMMUNOLOGY/*RADIOGRAPHY  *HIV-1  *HIV-2
       Lung/RADIOGRAPHY  Male  Tuberculosis,
       Pulmonary/COMPLICATIONS/IMMUNOLOGY/*RADIOGRAPHY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

