Clinical and radiographic features of HIV-related pulmonary tuberculosis according to the level of immunosuppression

• Autor(es):

  Garcia, Guilherme Freire (Fundação Hospitalar do Estado de Minas Gerais. Hospital Eduardo de Menezes, Universidade Federal de Minas Gerais. Faculdade de Medicina. Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical);

  Moura, Alexandre Sampaio (Fundação Hospitalar do Estado de Minas Gerais. Hospital Eduardo de Menezes, Universidade Federal de Minas Gerais. Faculdade de Medicina. Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical);

  Ferreira, Cid Sérgio (Universidade Federal de Minas Gerais. Faculdade de Medicina. Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical);

  Rocha, Manoel Otávio da Costa (Universidade Federal de Minas Gerais. Faculdade de Medicina. Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical).

• Fonte:

  Revista da Sociedade Brasileira de Medicina Tropical; volume 40, número 6, páginas 622-626. Dezembro 2007.

• Assuntos:

  Pulmonary tuberculosis;

  Acquired immunodeficiency syndrome;

  Thoracic radiography;

  CD4 lymphocyte count.

• Resumo:

  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.

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