Radiological Findings of Pulmonary Tuberculosis in Patients with and Without HIV Infections

Introduction: Radiological manifestation of pulmonary tuberculosis in HIV positive patients is different with HIV negative patients. We aim to determine the differences in chest radiological findings of Pulmonary Tuberculosis among HIV and non-HIV infected patients in HTAA. Materials and method: A retrospective study was conducted in Chest Clinic, Hospital Tunku Ampuan Afzan, Kuantan Pahang. There were 101 chest radiographs with sputum smear-positive retrieved and reviewed. Socio-demographic status and chest radiographs findings were documented and analyzed. Results: Of the 101 patients, 12 patients were HIV positive. Of the 89 HIV negative patients, 96% had consolidation change on chest radiograph, in contrast with HIV positive patients, only 4% among them had this appearance and this is statistically significant (p value less than 0.05). Mediastinal lymphadenopathy is significantly higher (17%) in HIV positive patients compared to HIV negative patients (1%). Normal chest radiographs were more common in HIV positive patients (33%) as compared to HIV negative patients (2%). Conclusion: HIV positive patients with pulmonary tuberculosis exhibit different radiological manifestation on chest radiograph when compared to HIV negative patients.

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Tuberculosis Status and Coinfection of Pulmonary Fungal Infections in Patients Referred to Reference Laboratory of Health Centers Ghaemshahr City during 2007-2017

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v28i6.2 ◽

1970 ◽

Vol 28 (6) ◽

Author(s):

Mohammad Reza Jabbari Amiri ◽

Rora Siami ◽

Azad Khaledi

Keyword(s):

Pulmonary Tuberculosis ◽

Fungal Infections ◽

Cross Sectional Study ◽

Health Centers ◽

Sputum Smear ◽

P Value ◽

Reference Laboratory ◽

Cross Sectional ◽

Pulmonary Fungal Infections ◽

Student’S T

BACKGROUND: Pulmonary tuberculosis is one of the most important health concerns. Pulmonary fungal infections have clinical and radiological characteristics similar to tuberculosis which may be easily misdiagnosed as tuberculosis. This study aimed to evaluate tuberculosis (TB) status and coinfection of TB with pulmonary fungal infections in patients referred to reference laboratory of health centers Ghaemshahr city during 2007-2017.METHODS: This cross-sectional study was conducted during eleven years, between 2007 2017, on 3577 patients with suspected TB referred to health centers of Ghaemshahr City. For isolation, sputum smear preparation and Ziehl-Neelson staining in companying with microscopy direct observation and KOH 10% + white Calcofluor staining was used. The culture of fungi was performed on Sabouraud Dextrose agar, Czapek and chrome agar media. Then, data were analyzed using SPSS software (version 16) through Student's t-test, Fisher test, and Odds Ratio. P values <0.05 were considered statistically significant.RESULTS: Of 3577 patients, 10731 smears were prepared, 3.6% (n=130) of patients were identified as smear-positive pulmonary tuberculosis, 86.4% (n=3090) were smear negative and 10% (n=357) drug-resistant TB. The mean age of patients was 48±1.8 years. With increasing age, the prevalence of TB has increased which was statistically significant (P value <0.05). Prevalence of tuberculosis in the age group over than 57 years in males and females had an ascending trend. Amongst the positive tuberculosis patients, 16/130 cases (12.3%) had the coinfection of TB with fungi microorganisms.CONCLUSION: Our findings showed the coinfection of fungi agents in patients with tuberculosis that should be considered.

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Comparison of chest radiographic findings among HIV positive and negative adults with smear positive Pulmonary Tuberculosis in Dar-es-salaam

Tanzania Medical Journal ◽

10.4314/tmj.v31i1.336 ◽

2020 ◽

Vol 31 (1) ◽

pp. 48-65

Author(s):

Balowa M. Baraka ◽

Mboka Jacob ◽

Ramadhani Kazema ◽

Tumaini Nagu ◽

Emmanuel Suluba ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Imaging Modality ◽

Left Lung ◽

Pulmonary Nodules ◽

Hiv Positive ◽

P Value ◽

Lung Field ◽

Tuberculosis Case ◽

Radiographic Findings ◽

Severe Immunosuppression

Background: Chest X-ray radiography is a widely available and cheap imaging modality used for identification of pulmonary tuberculosis (PTB) in suspected patients. Knowledge of discriminatory features of PTB among HIV infected patient is of utmost importance to improve tuberculosis case detection and consequently reduce morbidity and mortality associated with TB among HIV infected individuals. We aimed to describe chest radiographic findings among PTB patients and their association with HIV co-infection and CD4 levels among HIV positive patients.Methodology: A total of 170 newly diagnosed consented smear positive PTB patients underwent postero-anterior Chest radiographs (PA - CXR) and HIV testing. Determination of CD4 count was performed among HIV positive patients. The radiographs were interpreted using glossary of terms for thoracic radiology by two independent radiologists who were blinded to HIV diagnosis.Results: Study participants included 100 (58.9%) males and 70 (41.1%) females. Among these 54 (31.8%) had HIV/PTB co-infection. The pattern of radiographic findings among patients with PTB/HIV compared to PTB only were: pulmonary cavities 44.4% vs 61.2%, (p=0.04), alveolar consolidation 64.9% vs 81.7%, (p=0.04), upper zone consolidation 40.7% vs 57.8%, (p=0.039), middle zone consolidation 25.9% vs 44.8%, (p=0.019) and typical PTB 40.7% vs 57.8%, (p=0.039), respectively. Therefore, lesions were less likely to be observed among PTB/HIV compared to PTB only and the differences were statistically significant. When compared to PTB patients only HIV/PTB co-infected patients had more nodules on the left lung field 85.2% vs 60.9% (p=0.023); on each left lung zone upper 59.3% vs 34.4% (p=0.028); mid 77.8% vs 54.7% (p-value=0.039); lower 66.7% vs 34.4% (p=0.005) and miliary nodules 44.4% vs 15.6% (p=0.003), respectively. HIV/PTB co-infected patients with CD4 > 200 cells/μL had more mid zone consolidation (42.9% vs 15.2%, p=0.024).Conclusion: The commonest chest radiographic findings in HIV/PTB co-infected patients were pulmonary cavities and alveolar consolidation are associated with HIV negative status. HIV/PTB co-infected patients with severe immunosuppression had mid zone consolidation. Patients with severe immunosuppression showed less chest radiographic findings. HIV/PTB co-infection was highly associated with mid and lower zone pulmonary nodules and miliary nodules. Key words: PTB, HIV, CXR

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Sputum Smear Positive Pulmonary Tuberculosis Diagnostic Dropout Rate in Public Health Facilities, Addis Ababa, Ethiopia

Pulmonary Medicine ◽

10.1155/2019/2905615 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Daniel Melese Desalegn ◽

Kumera Terfa Kitila ◽

Boja Dufera Taddese ◽

Tinsae Kidanemariam Hailu ◽

Tariku Takle Dinku ◽

...

Keyword(s):

Public Health ◽

Pulmonary Tuberculosis ◽

Addis Ababa ◽

Dropout Rate ◽

Sputum Smear ◽

P Value ◽

Smear Microscopy ◽

Sputum Smear Microscopy ◽

Public Health Facilities ◽

Smear Positive Pulmonary Tuberculosis

Background. Prolonged laboratory diagnostic process of tuberculosis can lead to failure to complete the diagnosis and increase dropout rate of smear positive pulmonary tuberculosis (PTB) cases. This implies such dropout patients without completing diagnosis are critical as infected individuals remain untreated in the community, providing more opportunities for transmission of the disease and adversely affecting the epidemic. The aim of this research is to determine the level of smear positive PTB diagnosis dropout rate of spot-morning-spot sputum microscopy diagnosis method in public health facilities, in Addis Ababa, Ethiopia. Methods. Retrospective review of patient documents in 13 public health facilities’ TB laboratory in Addis Ababa was conducted from October 2011 to March 2016. Data was computerized using Epi-info software and analysed using SPSS version 20.0 software. Descriptive numerical summaries were used to present the findings. Association between the dropout rate and demographic variables was assessed by Chi-square (X2). Bivariate model using Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated. P-Value less than 0.05 was taken as statistically significant. Results. Of 41,884 presumptive TB patients registered during the 53 months for laboratory investigation, 5.9% were positive for the first spot sputum smear microscopy. Among these positive cases, 142 (5.8%) and 298 (12.1%) did not come back to the laboratory to submitted early morning and second spot sputum specimens, respectively. The diagnostic dropout for morning sputum specimen in hospitals was 5.6% (58/1039) and in health centres was 5.9% (84/1424). However, higher proportion of dropout for second spot sputum specimen in hospitals was 16.4% (170/1039), compared to the health centres, 8.9% (128/1424). Diagnostic dropout of sputum smear microscopy had no significant association with sociodemographic variable (P value >0.05), while it had significant association with facility type (P value <0.05). Conclusion. In this study smear positive pulmonary tuberculosis diagnostic dropout rate was high compared to WHO reported for the new strategy shift implying the importance of shifting to same-day approach. Hence, shifting from conventional to same day is crucial to minimize the TB diagnostic dropout rate in the study area and other similar settings. Further research is needed/recommended in the local setting to compare the yield and dropout rates between same-day and conventional sputum smear microscopy approach.

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Simultaneous Association of Pulmonary Tuberculosis and Kaposi’s Sarcoma in an Immunocompetent Subject: A Case Report and Literature Review

Case Reports in Pulmonology ◽

10.1155/2019/5453031 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3

Author(s):

Sofia Baina ◽

Jihane Achrane ◽

Jouda Benamor ◽

Jamal Eddine Bourkadi

Keyword(s):

Case Report ◽

Literature Review ◽

Pulmonary Tuberculosis ◽

Kaposi's Sarcoma ◽

Kaposi’S Sarcoma ◽

Hiv Positive ◽

Negative Patient ◽

Different Types ◽

Hiv Negative

Kaposi’s Sarcoma (KS) occurs as a pathological entity that may be classified into four different types: classic, endemic, epidemic, and iatrogenic. It can arise among HIV-positive subjects or within immunosuppression, yet exceptionally of tuberculous origin. We describe a new case report of an HIV-negative patient, manifesting Kaposi’s disease in the course of tuberculosis, with the aim to assess this uncommon disorder and to outline this rare atypical association.

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Risk, Persistence and Multiplicity of HPV Infections among HIV Negative and HIV Positive Nigerian Women

Journal of Global Oncology ◽

10.1200/jgo.2016.003830 ◽

2016 ◽

Vol 2 (3_suppl) ◽

pp. 38s-39s

Author(s):

Sally N. Adebamowo ◽

Toyosi Olawande ◽

Ayotunde Famooto ◽

Eileen O. Dareng ◽

Olayinka Olaniyan ◽

...

Keyword(s):

Cervical Cancer ◽

High Risk ◽

Hpv Infection ◽

Hiv Positive ◽

P Value ◽

Increased Risk ◽

Hiv Women ◽

Dna Enzyme Immunoassay ◽

High Risk Hpv ◽

Hiv Negative

Abstract 64 Background: The incidence, prevalence, persistence, and multiplicity of high-risk HPV infection is different between HIV positive and HIV negative women. We examined the association between HIV, prevalent HPV, and persistent HPV infections among women in a prospective cohort in Nigeria. Methods: We enrolled women presenting at cervical cancer screening programs in Abuja, Nigeria, between 2012 and 2014 and collected information on their demographic characteristics, risk factors of HPV infection, and cervical exfoliated cells samples at baseline, 6 month and 12 month follow-up visits. DNA enzyme immunoassay (DEIA) and Roche Linear Array HPV Genotyping Test were used to characterize HPV. Persistent HPV infection was defined as a positive result on 2 consecutive DEIA tests. We used logistic regression models to estimate the association between HIV and risk of HPV infection. Results: Among the 1,020 women enrolled, the mean age (±SD) was 37(8), and 44% and 56% were HIV+ and HIV-, respectively. HPV52 and 35 were the most common HPV types in the study population. The prevalence was 34% for any HPV, 24% for persistent HPV and 9% for multiple HPV infections; these were higher among HIV+ women (p-value <0.001). The multivariate odds ratio (OR) and 95 % CI comparing HIV+ to HIV- women was 6.29 (95% CI 3.64 – 10.87, p-value <0.001) for any high-risk HPV; 6.22 (95% CI 3.02 – 12.83, p-value <0.001) for persistent high-risk HPV; and 6.46 (95% CI 2.69 – 15.52, p-value <0.001) for multiple high-risk HPV infections, Conclusions: HIV infection is associated with increased risk of persistence and multiplicity of low-risk and high-risk HPV infections. These findings may explain, in part, the increased risk of cervical cancer among women with HIV infections. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Sally N. Adebamowo No relationship to disclose Toyosi Olawande No relationship to disclose Ayotunde Famooto No relationship to disclose Eileen O. Dareng No relationship to disclose Olayinka Olaniyan No relationship to disclose Richard Offiong No relationship to disclose Clement A. Adebamowo Speakers' Bureau: Merck [Table: see text]

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Clinical Features and Serum β2-Microglobulin Levels in HIV-1 Positive and Negative Tanzanian Patients with Tuberculosis

International Journal of STD & AIDS ◽

10.1177/095646249500600411 ◽

1995 ◽

Vol 6 (4) ◽

pp. 278-283 ◽

Cited By ~ 3

Author(s):

Nick Kennedy ◽

Fiona M Whitelaw ◽

Jacques Gutmann ◽

Leslie Berger ◽

Leonard Uiso ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Clinical Features ◽

Active Tuberculosis ◽

Hiv Positive ◽

Hiv Disease ◽

Β2 Microglobulin ◽

Median Serum ◽

Definition Of ◽

Hiv 1 ◽

Hiv Negative

Summary: Serum β2-microglobulin (β2M) rises in the later stages of HIV disease and has therefore been used to monitor progression to AIDS. However, little work has been done on patients co-infected with HIV and tuberculosis. We studied clinical features and serum β2-M in 35 Tanzanian patients treated for pulmonary tuberculosis (9 HIV-positive, 26 HIV-negative). The provisional WHO clinical definition of AIDS for use in Africa was fulfilled by 89% of the HIV-positive and 65% of the HIV-negative patients. Median serum β2-M on admission was slightly higher in HIV-positive (3.17 mg/l) than in HIV-negative (2.85 mg/1) patients. Serum β2-M fell during treatment in 17/24 (71%) of HIV-negative and 3/7 (43%) HIV-positive patients followed up for 6 months. We conclude that serum β2-M is frequently raised in active tuberculosis, and is therefore an unreliable indicator of the stage of HIV disease in co-infected patients. The WHO clinical definition of AIDS also proved unreliable in patients with tuberculosis.

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Negative sputum smear results in HIV-positive patients with pulmonary tuberculosis in Lusaka, Zambia

Tubercle and Lung Disease ◽

10.1016/0962-8479(93)90010-u ◽

1993 ◽

Vol 74 (3) ◽

pp. 191-194 ◽

Cited By ~ 100

Author(s):

A.M. Elliott ◽

K. Namaambo ◽

B.W. Allen ◽

N. Luo ◽

R.J. Hayes ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Hiv Positive ◽

Sputum Smear ◽

Negative Sputum

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Chest Radiograph Interpretation of Pneumocystis carinii Pneumonia, Bacterial Pneumonia, and Pulmonary Tuberculosis in HIV-Positive Patients

Journal of Thoracic Imaging ◽

10.1097/00005382-199701000-00007 ◽

1997 ◽

Vol 12 (1) ◽

pp. 47-53 ◽

Cited By ~ 51

Author(s):

Phillip M. Boiselle ◽

Irena Tocino ◽

Regina J. Hooley ◽

Andrew S. Pumerantz ◽

Peter A. Selwyn ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Chest Radiograph ◽

Pneumocystis Carinii Pneumonia ◽

Bacterial Pneumonia ◽

Pneumocystis Carinii ◽

Hiv Positive

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A study on cervical cytopathology in HIV positive pregnant women in Southern part of Assam, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20213473 ◽

2021 ◽

Vol 10 (9) ◽

pp. 3490

Author(s):

Arun Paul Choudhury ◽

Tanaya Acharyya

Keyword(s):

Viral Load ◽

Pregnant Women ◽

High Viral Load ◽

Antenatal Clinic ◽

Hiv Positive ◽

P Value ◽

Cervical Lesions ◽

Abnormal Cytology ◽

Cd4 Cell Count ◽

Hiv Negative

Background: The association between abnormal cervical cytology and HIV infection status in pregnant women was evaluated to correlate with CD4 cell count, viral load and ART compliance in HIV positive pregnant patients with the presence of ASC-US, LSIL and HSIL.Methods: Cervical samples were collected at the Antenatal Clinic of Silchar Medical College and Hospital. An Ayre’s spatula was used to collect samples from the ectocervix and a cytology brush to collect samples from the endocervix.Results: Of a total of 75 antenatal attendees, 43 were HIV positive and 32 were HIV negative. Abnormal cytology (N=26, 60.46%) was more common in HIV positive group compared to the HIV negative group (N=7, 21.87%) with a p value of <0.05. Cytological abnormalities were found to be associated with immunosuppression, defined as CD4 count <200 cells/mm3 and was also associated with high viral load(>10,000/mm3) and poor treatment follow up with ART.Conclusions: HIV positive pregnant women are more likely to have cervical lesions as compared to the HIV negative. This higher frequency of abnormal findings in PAP cytology in HIV positive pregnant women with higher viral loads suggest association between preinvasive cervical lesions and human immune deficiency.

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An outbreak of pulmonary tuberculosis and a follow-up investigation of latent tuberculosis in a high school in an eastern city in China, 2016–2019

PLoS ONE ◽

10.1371/journal.pone.0247564 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0247564

Author(s):

Yirong Fang ◽

Yan Ma ◽

Qiaoling Lu ◽

Jiamei Sun ◽

Yingxin Pei

Keyword(s):

High School ◽

Pulmonary Tuberculosis ◽

Chest Radiograph ◽

Index Case ◽

Variable Number Tandem Repeat ◽

Sputum Smear ◽

Post Exposure Prophylaxis ◽

Probable Case ◽

Post Exposure ◽

Latent Tb

Background In October 2016, a senior high school student was diagnosed with sputum-smear positive [SS(+)] pulmonary tuberculosis (TB). We conducted an investigation of an outbreak in the school, including among students and teachers diagnosed with latent TB, who we followed until July 2019. Methods We defined latent TB infection (LTBI) as a tuberculin skin test (TST) induration of 15mm or larger; probable TB as a chest radiograph indicative of TB plus productive cough/hemoptysis for at least 2 weeks, or TST induration of 15mm or larger; and confirmed TB as two or more positive sputum smears or one positive sputum smear plus a chest radiograph indicative of TB or culture positive with M. tuberculosis. We conducted mycobacterial interspersed repetitive unit–variable number tandem repeat (MIRU-VNTR) typing based on 24 loci in the isolates. Results Between October 2016 and July 2019, we identified 52 cases, including nine probable, six confirmed, and 37 LTBI cases. The index case-student had attended school continuously despite having TB symptoms for almost three months before being diagnosed with TB. We obtained three isolates from classmates of the index case in 2016; all had identical MIRU-VNTR alleles with the index case. The LTBI rate was lower among students (7.41%, 30/405) than among teachers (26.92%, 7/26) (rate ratio [RR] = 0.28, 95% confidential interval [CI]: 0.13–0.57). Among the 17 students who had latent TB and refused prophylaxis in October 2016, 23.53% (4/17) became probable/confirmed cases by July 2019. None of the six teachers who also refused prophylaxis became probable or confirmed cases. Of the 176 students who were TST(-) in October 2016, 1.70% (3/176) became probable/confirmed cases, and among the 20 teachers who were TST(-), 1 became a probable case. Conclusions Delayed diagnosis of TB in the index patient may have contributed to the start of this outbreak; lack of post-exposure chemoprophylaxis facilitated spread of the outbreak. Post-exposure prophylaxis is strongly recommended for all TST-positive students; TST-negative students exposed to an SS(+) case should be followed up regularly so that prophylaxis can be started if LTBI is detected.

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