Abdominal findings in AIDS-related pulmonary tuberculosis correlated with associated CD4 levels

Abstract.

Background: To document the abdominal manifestations of tuberculosis (TB) associated with human immunodeficiency virus (HIV) infection and to correlate those findings with CD4 levels.

Methods: Twenty-nine HIV-positive patients with culture-proven Mycobacterium tuberculosis infection were entered into the study. Chest changes were used to separate patients into two groups: those with and those without evidence of previous TB. All patients had standard chest radiographs, routine and high-resolution chest computed tomography (CT), and abdominal ultrasound examinations. Twenty-four patients had abdominal CT scans.

Results: The group of patients with no previous radiographic evidence of pulmonary TB had a significantly greater tendency to have manifestations of pulmonary and/or abdominal miliary dissemination. Those patients with radiological evidence of miliary dissemination were significantly more likely to have CD4 counts of less than 300.

Conclusions: Chest and abdominal miliary dissemination of TB in HIV-positive patients is significantly associated with radiologically determined primary onset pulmonary TB. These changes occur predominantly at CD4 counts of less than 300.