PULMONARY TUBERCULOSIS - COMPUTED-TOMOGRAPHY AND HIGH-RESOLUTION COMPUTED-TOMOGRAPHY PATTERNS IN PATIENTS WHO ARE EITHER HIV-NEGATIVE OR HIV-SEROPOSITIVE

To compare findings of active pulmonary tuberculosis on computed tomog raphy (CT) and high-resolution computed tomography (HRCT) scans in pat ients without the human immunodeficiency virus (HIV) and patients with HIV, and to define the spectrum of pulmonary tuberculosis in patients with HIV according to the CD4 T cell status. 76 patients (47 patients without HIV and 29 patients with HIV) with newly diagnosed pulmonary tuberculosis were studied retrospectively. The diagnosis of active pul monary tuberculosis was based on acid-fast bacilli (AFB) in sputum cul ture. All patients underwent CT within 1 month of diagnosis. Patients with HIV demonstrated significantly less cavitation and bronchial wall thickening (24% vs. 49% [p < 0.05]; and 14% vs. 45% [p < 0.01], respe ctively) than the combined group of patients with HIV. Centrilobular n odules were significantly less common in patients without HIV (14% vs. 45%, p < 0.05). Lymphadenopathy with low attenuation centers was sign ificantly less frequent in the patients with HIV (3% vs. 15%, p < 0.05 ). In patients with HN? cavitation, lymphadenopathy. as well as the th e number of nodules and the number of lobes involved correlated well w ith the CDS levels. Two patients with less than 50 CD4 T cells/mm(3) h ad normal chest CT results. Atypical chest CT patterns are frequently encountered in patients with HIV. Knowledge of these CT patterns may a ssist in the diagnosis and follow-up of patients with HIV with known o r suspected pulmonary tuberculosis.