PULMONARY TUBERCULOSIS - COMPARISON OF CT FINDINGS IN HIV-SEROPOSITIVE AND HIV-SERONEGATIVE PATIENTS

PURPOSE: To determine the differences in the computed tomographic (CT) appearance of pulmonary tuberculosis (TB) between patients with and p atients without human immunodeficiency virus (HIV) infection. MATERIAL S AND METHODS: CT scans and chest radiographs of 42 HIV-seropositive a nd 42 HIV-seronegative patients with pulmonary TB were reviewed. CD4 T -lymphocyte counts, measured in 40 seropositive patients, were at leas t 200 cells per microliter in 10 patients and were less than 200 cells per microliter in 30. RESULTS: Seropositive patients had a higher pre valence of lymphadenopathy at chest radiography (P < .05). The seropos itive patients had a lower prevalence of consolidation (P <.05), cavit ation (P <.01), and postprimary pattern (P <.05) at CT. HIV-seropositi ve patients had a higher frequency of miliary (P <.01) and extrapulmon ary disease (P < .001). Similar features of pulmonary TB were observed in seropositive patients with mild and severe immunosuppression. CONC LUSION: HIV-seropositive patients had a lower prevalence of localized parenchymal disease and a higher prevalence of disseminated disease at CT.