Pulmonary tuberculosis: comparison of CT findings in HIV-seropositive and HIV-seronegative patients.

Purpose: To determine the differences in the computed tomographic (CT) appearance of pulmonary tuberculosis (TB) between patients with and patients without human immunodeficiency virus (HIV) infection.

Materials And Methods: CT scans and chest radiographs of 42 HIV-seropositive and 42 HIV-seronegative patients with pulmonary TB were reviewed. CD4 T-lymphocyte counts, measured in 40 seropositive patients, were at least 200 cells per microliter in 10 patients and were less that 200 cells per microliter in 30.

Results: Seropositive patients had a higher prevalence of lymphadenopathy at chest radiography (P< .05). The seropositive patients had a lower prevalence of consolidation (P< .05), cavitation (P< .01), and postprimary pattern (P< .05) at CT. HIV-seropositive patients had a higher frequency of miliary (P< .01) and extrapulmonary disease (P< .001). Similar features of pulmonary TB were observed in seropositive patients with mild and severe immunosuppression.

Conclusion: HIV-seropositive patients had a lower prevalence of localized parenchymal disease and a higher prevalence of disseminated disease at CT.