The Chest Roentgenogram in Pulmonary Tuberculosis Patients Seropositive for Human Immunodeficiency Virus Type 1

Long, Richard; Maycher, Bruce; Scalcini, M; Manfreda, Jure

doi:10.1378/chest.99.1.123

Cited by 129 publications

(64 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(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). All of the HIV-patients with multifocal disease also presented other opportunistic diseases.…”

Section: Discussioncontrasting

confidence: 45%

“…(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%

“…The differences found in the presentation of TB in HIV-positive patients are due to cellular immunodeficiency secondary to the progressive destruction of CD4 lymphocytes by HIV, (4,6,9,10) and the tuberculous lesions can result from the reactivation of old foci or from re-infection. (4,6,8) Therefore, CD4 counts in peripheral blood are used to evaluate the immunological status of patients infected with the virus, and the counts thus obtained can be correlated with the clinical and radiological presentation of TB.…”

Section: Introductionmentioning

confidence: 99%

“…(4,6,8) Therefore, CD4 counts in peripheral blood are used to evaluate the immunological status of patients infected with the virus, and the counts thus obtained can be correlated with the clinical and radiological presentation of TB. (3,(6)(7)(8)(9)(10)(11)(12) When TB manifests in HIV-positive patients with relatively preserved immunity (CD4 > 350 cells/mm 3 ), the clinical and radiological presentation is similar to that seen in individuals who are not infected with HIV (HIV-negative individuals).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2007

View full text Add to dashboard Cite

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...

show abstract

Section: Discussioncontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2007

View full text Add to dashboard Cite

show abstract

“…In Long and colleagues' series of 67 HIV-infected patients with tuberculosis, 80% of those with AIDS had atypical chest radiographs. 26 In a study by Keiper et al, 21 (81%) of 26 patients with tuberculosis who had CD4 counts below 200/mm 3 presented with atypical chest radiographs, compared with only 1 (11%) of 9 subjects with CD4 counts above 200/mm 3 . 27 …”

Section: Tuberculosismentioning

confidence: 95%

Diagnosing HIV-Related disease

Jung

Paauw

1998

J Gen Intern Med

View full text Add to dashboard Cite

OBJECTIVE: To summarize current information on the relation between CD4 counts and the risk of different HIV-related diseases. MEASUREMENTS AND MAIN RESULTS: MEDLINE search ofEnglish language articles between 1985 and 1996 using the medical subject heading (MeSH) term "CD4 lymphocyte count" and searches using key words of multiple HIV-related diseases were conducted. Some HIV-related diseases can be stratified to different CD4 count levels. Regardless of their CD4 count, HIV-infected patients are susceptible to sinusitis, Kaposi's sarcoma, community-acquired pneumonia, and oral hairy leukoplakia. In advanced HIV, when CD4 is below 200/ mm 3 , Pneumocystis carinii pneumonia, toxoplasmosis, progressive multifocal leukoencephalopathy, Mycobacterium avium complex, molluscum contagiosum, and bacillary angiomatosis all increase in incidence. In very advanced HIV disease, when CD4 counts are below 50/mm 3 , patients are at risk of pseudomonas pneumonia, cytomegalovirus retinitis, central nervous system lymphoma, aspergillosis, and disseminated histoplasmosis.KEY WORDS: CD4 count; HIV-related disease; risk stratification. J GEN INTERN MED 1998;13:131-136.

show abstract

HIV‐Associated Tuberculosis: Clinical Challenges

Schluger

2009

AIDS and Tuberculosis

View full text Add to dashboard Cite

The Chest Roentgenogram in Pulmonary Tuberculosis Patients Seropositive for Human Immunodeficiency Virus Type 1

Cited by 129 publications

References 9 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

Diagnosing HIV-Related disease

HIV‐Associated Tuberculosis: Clinical Challenges

Contact Info

Product

Resources

About