Correlation between CD4 count and radiological findings of disease of the nasal sinuses in HIV-positive patients

Background and objective: Sinusitis is a frequent and typical disease in HI V-positive patients. It was the aim of this study to examine retrospectivel y computed tomograms (CT)and magnetic resonance images (MRI) of such patien ts for sinusitis. Patients and methods: CT and MRI of the nasal sinuses were retrospectively analysed in 71 HIV-positive patients. Results: Sinusitis was diagnosed in 49 of the 71 patients by conventional r adiology (38), CT(13) and/or MRI. In patients with sinusitis, contrary to t hose without it, there was a significant correlation between progression of the HIV infection, as measured by reduction in CD4 count, and an increased number of symptoms (r = - 0.297; p < 0.05). The latter also correlated sig nificantly with the frequency of concomitant sinusitis (r = 0.336, p < 0.05 ). The radiological findings correlated more closely with the CD4 count whe n tomography was used. The correlation coefficient for the number of patien ts with concomitant sinus disease rose from r = -0.305 to r = -0.459 and fo r the degree of severity from r = -0.324 to r = -0.484 (p < 0.05). Severity of sinus disease was clearly more marked among HIV-positive than HIV-negat ive patients. Conclusion:The severity of sinusitis in HIV-positive patients correlated di rectly with the level of the CD4 count. In these patients tomographic metho ds are preferable to conventional radiology.