[Radiological features of AIDS complicated by pulmonary tuberculosis and the association with CD4+ T lymphocytes].
OBJECTIVE
To explore the imaging features in cases with AIDS complicated by pulmonary tuberculosis and the association with CD(4)(+) T lymphocytes.


METHODS
A retrospective analysis was carried out of the manifestations of chest X-rays in patients with late stage AIDS complicate by pulmonary tuberculosis (n = 26 cases) and patients with pulmonary tuberculosis only (n = 60 cases). The results of measurements of CD(4)(+) T lymphocytes were compared.


RESULTS
(1) The chest X-ray features in patients with AIDS complicated by pulmonary tuberculosis showed more patchy and blurring shadows (53.8% vs 8.3%; P < 0.01), more military changes (23.1% vs 5.0%; P < 0.05), more enlarged intrathoracic lymph nodes (34.6% vs 8.3%; P < 0.01) as well as more extra-pulmonary tuberculous processes (23.1% vs 3.3%; P < 0.05) as compared to patients with pulmonary tuberculosis alone. Fewer upper lung or apical lesions (23.1% vs 76.7%; P < 0.01), as well as less consolidation (11.5% vs 71.7%; P < 0.01) and cavity formation (7.7% vs 30.0%; P < 0.05) were found in AIDS patients. No significant difference was found in the occurrence of hydrothorax (11.5% vs 20.0%; P > 0.05). (2) The relative numbers of CD(4)(+) T lymphocytes in patients with AIDS complicated by pulmonary tuberculosis and in patients with pulmonary tuberculosis alone were (5.0 +/- 6.4)% and (65.3 +/- 1.5)% respectively. Atypical manifestations of tuberculosis were found in 15 out of the 26 cases of AIDS patients showing a CD(4)(+) T lymphocytic count < 50/microl, in 3 of the 4 cases with the count between 50/microl - 100/microl, while in cases with CD(4)(+)T lymphocytic count between 100/microl -200/microl (n = 4) and > 200/microl (n = 2), numbers of atypical tuberculosis were 2 and 0 respectively.


CONCLUSIONS
The chest X-ray changes of tuberculosis in cases with late stage AIDS were mostly of the atypical pattern, and were related to a significant decrease in CD(4)(+)T lymphocyte count.
Lu
Pu-xuan
PX
Department of Radiology, Shenzhen East Lake Hospital, Shenzhen 518020, China.
Yu
Wei-ye
WY
Zhu
Wen-ke
WK
Liu
Yan
Y
Liu
Jin-qing
JQ
D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging* / Q000276:immunology*