Abstract
Objective: to study the CT semiotics of respiratory tuberculosis in HIV-infected patients in relation to the degree of immunosuppression.
Material and methods. The study enrolled 98 patients with verified respiratory tuberculosis in the presence of HIV infection. According to the degree of immunosuppression and the Centers for Disease Control (CDC, Atlanta, USA, 1993), the patients were divided into 3 groups: 1) CD4 ≥500 cells/ul (n = 12); 2) CD4 200-499 cells/ul (n = 34); 3) CD4 <200 cells/ul (n = 52).
Results.
CT manifestations of tuberculosis depending on the level CD4
With spiral CT, focal changes with a predominance of clear-cut foci are visualized at a high frequency in the patients with pulmonary tuberculosis in the presence of HIV infection. In progressive immunosuppression, the CT pattern displays atypical syndromes (frosted glass-type foci, interstitial infiltration, and thin-walled cavities) with the lower rate of alveolar infiltration, as well as lung tissue decay. Enlarged intrathoracic lymph nodes are characteristic of 70.0% of the patients with HIV infection and tuberculosis regardless of the level of CD4 cells.
Conclusion. As immunosuppression progresses, the CT pat-tern of respiratory tuberculosis in the presence of HIV infection shows as atypical syndromes.
- © 2014 ERS
