Pleural tuberculosis and HIV infection.
Human immunodeficiency virus infection changes the clinical presentation of tuberculosis infection with atypical radiographs and more common extra-pulmonary involvement. We retrospectively studied pleural tuberculosis in HIV-positive patients over a 5-year period. We identified 70 patients with pleural tuberculosis by positive Mycobacterium tuberculosis cultures of pleural fluid and/or pleural tissue, including 43 HIV-positive and 27 HIV-negative patients. The HIV-positive patients were significantly younger (mean age, 38 +/- 1 years in HIV-positive vs 52 +/- 3 years in HIV-negative patients, p < 0.05). There were more intravenous drug abusers in the HIV-positive group (74 vs 30 percent, p < 0.01). The HIV-positive group had significantly fewer positive tuberculin skin tests (41 percent vs 76 percent, p < 0.03). Both groups had similar pleural fluid cellularity and pleural biopsy histologic conditions, but the HIV-positive patients demonstrated significantly more acid-fast bacteria identifiable in pleural tissue (69 percent vs 21 percent, p < 0.01), and a higher incidence of positive M tuberculosis cultures of sputum (53 percent vs 23 percent, p = 0.02). Pleural tuberculosis in HIV-positive patients presented more often as a manifestation of a greater burden of microorganisms and impaired host response.
Relkin
F
F
Bellevue Hospital, Department of Medicine, New York.
Aranda
C P
CP
Garay
S M
SM
Smith
R
R
Berkowitz
K A
KA
Rom
W N
WN
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis; D000328:Adult; D001707:Biopsy, Needle; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010994:Pleura / Q000473:pathology; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012307:Risk Factors; D014374:Tuberculin Test; D014396:Tuberculosis, Pleural / Q000150:complications* / Q000175:diagnosis