Showing papers by "S. Chandrasekhar published in 2007"
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TL;DR: The radiographic presentation of pulmonary tuberculosis in HIV-infected patients is atypical with less cavitation, and more dissemination on completion of anti-tuberculosis treatment, which may be due to the reduced inflammatory response that patients with HIV infection may be able to mount.
Abstract: Background. There is insufficient data on the radiographic presentation of tuberculosis in human immunodeficiency virus
(HIV) infected patients from India.
Methods. We examined the chest radiographs of 181 patients including 82 HIV positives with newly diagnosed sputum
culture positive pulmonary tuberculosis before and after the completion of anti-tuberculosis treatment (ATT). Patients with
smear/culture positive pulmonary tuberculosis were treated with Revised National Tuberculosis Control Programme
(RNTCP) Cat-I regimen (2EHRZ3/4HR3). An independent assessor blinded to HIV and clinical status of patients read the
radiographs.
Results. At presentation, HIV seropositive patients were significantly more likely to have normal chest radiographs (14.2%
vs 0), miliary tuberculosis (10.7% vs 1%) and pleural effusion (16.6% vs 3%), and less likely to have cavitation (17.8% vs
39.4%) as compared to HIV negative patients. At the end of treatment, HIV positive patients were more likely to have normal
radiographs (42.8% vs 1.2%), and less likely to have fibrosis (17.8% vs 42.5%).
Conclusions. The radiographic presentation of pulmonary tuberculosis in HIV-infected patients is atypical with less
cavitation, and more dissemination. On completion of ATT, patients with HIV have less radiographic sequelae in the form
of fibrosis. These features may be due to the reduced inflammatory response that patients with HIV infection may be able
to mount.
19 citations