Pulmonary radiological characteristics in patients with HIV infection at the time of highly active antiretroviral therapy (HAART).
OBJECTIVE
To report on radiological and epidemiological characteristics of pulmonary disease in patients with HIV infection in times of highly active antiretroviral therapy (HAART).


METHODS
Clinical data of 130 HIV infected adults with acute pulmonary symptoms were compared with findings in chest radiography (n = 130) and computed tomography (CT, n = 42). Presence and distribution of consolidation, interstitial changes, pleural effusion, and adenopathy were evaluated. Results were compared to findings from sputum, bronchoalveolar lavage, transbronchial biopsy, or empirical therapy results.


RESULTS
48% of patients presented pathologic findings. Overall sensitivity for the detection of pulmonary involvement was 0.87 (chest radiography) vs. 0.97 (CT). Disease specific sensitivity was 0.33 compared to 0.70. Bacterial pneumonia (BP, n = 26, 20%) was the most frequent diagnosis, followed by pneumocystis jiroveci pneumonia (PJP, n = 17, 13%), mycobacterium avium complex (MAC, 6%), Kaposi's sarcoma and lymphoma (KS and NHL, each 4%), fungal pneumonia (2%), and tuberculosis (TBC, 1%). Focal pulmonary infiltration was predominantly present in BP (50%, n = 13). Reticular (35%; n = 6) and micronodular (35%; n = 6) infiltration were predominantly found in PJP.


CONCLUSIONS
Despite HAART, lung involvement is still common. Only contrast-enhanced computed tomography shows an acceptable disease-specific sensitivity. In unclear cases, CT should be performed.
Schlossbauer
T
T
Institute of Clinical Radiology, University of Munich, Germany. thomas.schlossbauer@med.uni-muenchen.de
Schmidt
G P
GP
Bogner
J R
JR
Sing
A
A
Reiser
M F
MF
Becker-Gaab
C
C
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*