1. Pulmonary radiological characteristics in patients with HIV infection at the time of highly active antiretroviral therapy (HAART).
- Author
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Schlossbauer T, Schmidt GP, Bogner JR, Sing A, Reiser MF, and Becker-Gaab C
- Subjects
- Acquired Immunodeficiency Syndrome complications, Acquired Immunodeficiency Syndrome drug therapy, Adult, Aged, Humans, Lung Diseases complications, Lung Diseases drug therapy, Male, Middle Aged, Radiographic Image Enhancement methods, Retrospective Studies, AIDS-Related Opportunistic Infections diagnosis, Acquired Immunodeficiency Syndrome diagnostic imaging, Antiretroviral Therapy, Highly Active, Lung Diseases diagnostic imaging, Radiography, Thoracic, Tomography, X-Ray Computed methods
- Abstract
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.
- Published
- 2007