ROLE OF HRCT THORAX IN DETECTION AND CHARACTERIZATION OF PULMONARY PATHOLOGIES IN HIV PATIENTS WITH LOW CD4 COUNTS- A PROSPECTIVE OBSERVATIONAL STUDY

Sharma Ashok Kumar, Pawar Shephali Shrikant

Abstract


Background: Human immunodeficiency virus (HIV) weakens the host immune system and makes them prone to various opportunistic infections
and malignancies. Etiology and patterns of pulmonary pathologies in HIV patients depend on CD4 counts, which is a measure of
immunosuppression.
Aims: This study was conducted to assess the pattern of pulmonary infection in HIV patients with low CD4 counts using conventional chest X-ray
(CXR) and High-Resolution Computed Tomography (HRCT) thorax and further to compare the findings of both CXR and HRCT.
Subjects and Methods: The study was carried out over a period of 18 months including 50 consenting HIV patients with CD4 count less than 500
cells/μl having clinical symptoms like cough and fever. All the participants were sent for chest radiograph as well as HRCT thorax plain and
contrast.
Statistical analysis used: All data were analyzed by Chi-Square test and One-way ANOVA with SPSS 16.0 software.
Results: The mean CD4 count was 232.5±132 cells/μl. The diagnosis based on abnormal HRCT included cases of Pulmonary Tuberculosis (36%),
Bronchopneumonia (10%), Viral pneumonia (4%), metastasis from Hepatocellular carcinoma (4%), Angioinvasive aspergillosis (2%), metastasis
from NHL (2%), lung adenocarcinoma (2%), cardiomyopathy (2%) and chronic kidney diseases (2%) in HIV patients. There was no significant
correlation with CD4 count and pulmonary pathologies. However, all patients with Miliary TB, PJP, aspergillosis and CMV had CD4 count less
than 200 cells/μl.
Conclusions: We concluded that HRCT thorax is a highly sensitive tool for detecting HIV associated opportunistic infections as well as lesions and
allows their better characterization.


Keywords


HIV, Low CD4 count, HRCT thorax, Opportunistic infections.

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