Thoracic computed tomography of patients infected with the human immunodeficiency virus: Relevance for the course of disease

To determine the diagnostic accuracy and prognostic implications of thoraci c computed tomography (CT) in patients with human immunodeficiency virus in fection (HIV), CT scans of 154 HIV-infected patients (mean age, 41 years; r ange 23-65 years; 18 female) with suspicion of pulmonary disease were retro spectively reviewed for signs of disease by two investigators blinded to cl inical data other than positive HIV serology. Abnormal CT features were cor related with CD4-T lymphocyte count, histologic or microbiologic diagnosis, and survival. Computed tomography detected features of pulmonary disease i n 133 patients. A recent chest film was available in 96 patients, and it wa s normal in 16. Tn 17 of 99 patients (17%) with histologic or microbiologic correlation, pathologic CT features could be demonstrated, though histolog ic and microbiological studies were unrevealing. Median survival was 649 da ys. Confluent pulmonary infiltrates and bilateral masses on CT indicated ad vanced disease with a median survival of 115 days (n = 11, p = 0.0005) and 174 days (n = 15, p < 0.0001), respectively. The authors concluded that tho racic CT detects pulmonary lesions in an appreciable portion of HN-infected patients in whom chest radiographs, microbiologic methods, or histology fa iled to establish a diagnosis, and that CT findings allow for an estimation of patient survival in acquired immunodeficiency syndrome.