RADIOLOGICAL FEATURES OF PULMONARY TUBERCULOSIS IN 963 HIV-INFECTED ADULTS AT 3 CENTRAL AFRICAN HOSPITALS

Tuberculosis is one of the most important infectious complications in human immunodeficiency virus (HIV)-infected individuals in sub-Saharan Africa, In this radiological study, me detail the chest radiographic findings of Zairean and Zambian adults with a diagnosis of AIDS and tu berculosis as seen at three Central African Hospitals, Between 1992 an d 1995, consecutive chest radiographs of 963 HIV-infected adults aged between 16 Sears and 56 years with microbiologically confirmed tubercu losis (TB) were reviewed: (1) 362 adults from Sendwe General Hospital, Lubumbashi, Zaire, (2) 175 from Mama Yemo Hospital, Kinshasa, Zaire, and (3) 426 adults from The University Teaching Hospital (UTH), Lusaka , Zambia, During the same period consecutive chest radiographs from 10 00 age-matched HIV-negative adults with tuberculosis mere collected fo r comparative purposes, Comparison of the two groups showed that the H IV-infected group of patients with tuberculosis had a significantly hi gher proportion of lymphadenopathy (26% vs 13%; P = 0.001), pleural ef fusions (16% vs 6.8%; P = 0.001), miliary shadowing (9.8% vs 5%; P = 0 .001), an interstitial pattern (12% vs 7%; P = 0.01) and consolidation (10% vs 3%; P = 0.001), There mas significantly less cavitation (33% vs 78%; P = 0.001) and atelectasis (12% vs 24%; P = 0.001) seen in the HIV-positive group compared to the HIV-negative group of patients, Th ese patterns of radiographic changes mere consistently seen across all three hospital sites, The radiographic appearances in HIV-infected in dividuals with TB is discussed.