A study of radiological features as seen on a chest radiograph of a patient with both human immunodeficiency virus infection and pulmonary tuberculosis

This study was done at the Aga Khan Hospital, Nairobi and Kiambu Hospital. !n the period of study 160 patients were seen to have AFB positive sputums or gastric aspirates. Out of this number 72 Radiographs of the chest were analysed. The presence of upper zone disease (HIV+ve 7/20 (35%), HIV -ve 36/52 (72%), cavltatlon (HIV +ve 4/20 (20%), HIV-ve 28/52 (56%) and normal mediastenum width HIV +ve 7/20 (35%),HIV-ve 7/52 (14%) were found to indicate absence of HIV infection while the reverse lS also true. The absence of upper region involvement, lack of cavitation, enlarged mediastenum and normally positioned hilum were found to have a positive predictive values of (18/20) 90%. However mediastenum enlargement, lower and midzon disease and lack of cavitation when taken together were found not to be significantly different in the two groups (HIV+ve and HIV -ve) 0 Therefore the involvement of the upper zone is very important in trying tq differentiate the two. I therefore suggest that in the absence of HIV testing facilities the above features may be useful in identifying HIV infection among pulmonary tuberculosis patients. (author)