Chest radiography and beta-2-microglobulin levels in HIV-seronegative and HIV-seropositive African patients with pulmonary tuberculosis.
To examine the relationship between radiographic features, serum beta-2-microglobulin (beta-2-M) levels, results of sputum-smear microscopy and outcome, we performed a retrospective study of 99 HIV-seropositive and 162 HIV-seronegative patients with pulmonary tuberculosis (TB) in Dar es Salaam, Tanzania. Radiographic features of primary TB were more common and features of postprimary TB less common in HIV-seropositive compared to seronegative patients (50% vs 31%, p < 0.002; and 40% vs 63%, p < 0.001), respectively). HIV infection had a strong independent effect on the beta-2-M levels. Among HIV-infected patients radiographic findings of primary TB were significantly more often associated with beta-2-M levels of > 4 mg/l than features of postprimary TB (71.1% vs 44.4%, p < 0.02). In patients with features of postprimary TB, acid-fast bacilli were more often detected in sputum smears than in patients with primary TB (65% vs 47%, p > 0.05, in HIV-seropositive patients; and 63% vs 31%, p < 0.001) in seronegative patients). The observed mortality was too low to identify radiographic predictors of survival. We conclude that HIV-infected patients with features of primary pulmonary TB are likely in an advanced stage of HIV infection and deserve close supervision during anti-tuberculous therapy.
Department of Medicine, Ministry of Health, Dar es Salaam, Tanzania.
C
C
Richter
K J
KJ
Pallangyo
B N
BN
Ndosi
H J
HJ
Chum
A B
AB
Swai
J
J
Shao
D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000328:Adult; D005260:Female; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D013636:Tanzania / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D001613:beta 2-Microglobulin / Q000378:metabolism*
D001613:beta 2-Microglobulin