High-Resolution Computed Tomography Lung Spectrum In Symptomatic Adult Hiv-Positive Patients In Correlation With Cd-4 Count

ABSTRACT

Context Pulmonary disease accounts for 30–40% of the acute hospitalizations of HIV-positive patients. The CD4 count, anindicator of the severity of immune compromise, is of paramount importance for rendering an appropriate differential diagnosis.High-resolution computed tomography (HRCT) of lung provides detailed visualization of lung parenchyma and can characterizediseases according to pattern and distribution which can help in formulating a differential diagnosis.Aims: The aims of this study were as follows (1) To identify the radiological appearance/pattern of HIV-associated infections.(2) To correlate the radiological findings with CD4 count.Settings and Design: This was a cross-sectional study using sample size of 100 HIV-infected patients conducted at theDepartment of Radiodiagnosis and Imaging, Gandhi Medical College and Hamidia Hospital, Bhopal.Materials and Methods: A total of 100 adult HIV-infected patients were scanned with HRCT chest and findings were documentedand correlated with their CD4+ counts.Statistical Analysis Used Data analysis was done using SPSS 21.0. Two-tailed P < 0.05 was considered statistically significant.Results: TB (70%) was the most common infection followed by bacterial pneumonia (14%) and Pneumocystis jiroveci pneumonia(6%). Tuberculosis was found in 29% of advance CD4 count patients and 27% of severe CD4 count patients. Consolidation,airspace nodules, miliary nodules, diffuse ground-glass opacity, and pleural effusion showed significant correlation with CD4counts.Conclusions: Incidence of all these manifestations fairly correlates with the decline of CD4 counts. Early and proper diagnosisof these pulmonary complications in patients with HIV infection and lower CD4 counts will help clinicians to develop a focusedtherapeutic approach in their management.