Radiographic alterations in patients presenting human immunodeficiency virus/tuberculosis coinfection: correlation with CD4+ T cell counts.
OBJECTIVE
To look for correlations between radiological patterns and CD4+ T cell counts in patients coinfected with tuberculosis and human immunodeficiency virus.


METHODS
Patients included were selected from among those presenting human immunodeficiency virus/tuberculosis coinfection and admitted to the Nereu Ramos Hospital, located in Florianópolis, Brazil, between January of 2000 and December of 2003.


RESULTS
A total of 87 patients were included. The mean age was 34 +/- 8 years, and 6.8% were non-Caucasian. The mean CD4+ T cell count was 220.2 cells/mm(3) (median, 144 cells/mm(3)), and 56.4% of the patients presented less than 200 cells/mm(3). We identified the following radiographic patterns and related them to the CD4+ T cell counts: the alveolar pattern in 50.6% of the cases (56.8% CD4+ T cells < 200); the interstitial pattern in 32.2% (53.6% CD4+ T cells < 200); pleural effusion in 24.1% (47.6% CD4+ T cells < 200); cavitation in 24.1% (57.1% CD4+ T cells < 200); enlarged mediastinal or hilar lymph nodes in 11.5% (90% CD4+ T cells < 200); and a normal pattern in 11.5% (60% CD4+ T cells < 200). The mean CD4+ T cell counts for the radiologic patterns isolated were as follows: 235.2/mm(3) (alveolar consolidation); 208.8/mm(3) (interstitial); 243.3/mm(3) (pleural effusion); 265/mm(3) (cavitation); 115.1/mm(3) (enlarged mediastinal or hilar lymph nodes) (p < 0.05); and 205.5/mm(3) (presenting no radiological alterations). As noted, mediastinal/hilar lymph node enlargement was the only pattern that correlated with the degree of cell-mediated immunity in a statistically significant way.


CONCLUSIONS
With the exception of mediastinal/hilar lymph node enlargement, the radiographic patterns were randomly distributed in relation to the CD4+ T cell counts.
da Silva
Rosemeri Maurici
RM
Universidade do Sul de Santa Catarina, Florianópolis, SC, Brasil. rmaurici@unisul.br
da Rosa
Lígia
L
Lemos
Renata Nunes
RN
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000000981:diagnostic imaging* / Q000276:immunology*; D000328:Adult; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging* / Q000276:immunology*