Chest Radiographic Findings In Sputum Linear Positive Tuberculosis Patients and Human Immunodeficiency Virus/Tuberculosis Co-Infected Patients Treated In a Chest Unit, Enugu, Nigeria

Abstract

Aim: To evaluate the chest radiographic changes in patients with sputum smear   positive pulmonary tuberculosis (PTB)and patients with Human immunodeficiency virus / pulmonary tuberculosis eo-infection
(HIV/PTB).
Materials and Methods: The study was a case-control study conducted in the chest unit of University of Nigeria Teaching Hospital, Enugu between 2000 to 2004. The cases were the HIV/PTB eo-infected persons while controls were patients with only PTB. HIV status and sputum smear
microscopy results were obtained from the case files while their chest' radiographs (CXR),were reported by the radiologists.
Results: A total of 479 cases were studied out ofwhich 296(61.8%) had only PTBwhile 183 (38.2%) had HIV/PTB eo-infection. There were significantly more cavitary lesions, less hilar shadows and more upper
lobe infiltrates in PTBpatients compared to HIV/PTB eo-infected patients (P= 0.00). The CXR findings were however significantly more atypical in HIV/PTB eo-infected persons than in those. with only PTB (P = 0.00).
Conclusions: CXRfindings in patients with HIV/PTB eo-infection are more atypical than those of patients with only PTB infection. A high index of suspicion is therefore required when an atypical CXRis observed in a HIV patient presenting with clinical signs and symptoms suggestive of TB.