Gambaran Radiografi Toraks Pasien HIV Dengan Tuberkulosis Paru Berdasarkan Nilai CD4 Di Rumah Sakit Umum Arifin Achmad Provinsi Riau

Jendriella Jendriella, Dian Yazmiati, Andreas Makmur, Azizman Saad

Abstract

Diagnosis of tuberculosis in HIV-Tuberculosis coinfected patients is difficult. Thorax x-ray is a primary tool to evaluate tuberculosis in HIV. The purpose of this cross-sectional study was to assess and compare various radiological patterns of pulmonary tuberculosis in HIV patients with CD4 counts. This study conducted in Arifin Achmad Hospital Riau province from December 2016-December 2018 with 55 HIV-tuberculosis coinfected patients. WHO guidelines were used for diagnosis of HIV and tuberculosis. 100% of the patients had sputum positive pulmonary tuberculosis, with higher incidence (83,6%) among CD4 less than 200 as compared to CD4 more than 200 (16,4%). Infiltration (32,7%) followed by normal (18,2%), and fibrosis (11%) seen with CD4 less than 200. Infiltration (9,2%) followed by normal
(3,6%) and fibrosis (1,8%) with CD4 above 200. Mid and lower zone (50%) more commonly seen in CD4 < 200. Despite in CD4 >200 upper zones more commonly seen. Most lesions were found in mid zone of lung. There were significant differences in radiological patterns of pulmonary tuberculosis in HIV according to CD4 counts.

Keywords

Tuberculosis, Thorax-Xray, CD4

Full Text:

PDF

References

Daley CL, Gotway MB, Jasmer RM. Radiographic manifestations of tuberculosis : a primer for clinicians. San Fransisco : Francus J. Curry National Tuberculosis Center: August 2003.

Ngowi BJ, M FInanga SG, Bruun JN and Morkve O. Pulmonary tuberculosis among people living with HIV/AIDS attending care and treatment in rural northern Tanzania. BMC : Public Health 2008, 8:341.

Fauci AS, Lane HC. Human Immunodeficiency Virus Disease: AIDS and related disorders. In: Fauci AS, Braunwald, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., ed. Harrison’s Principles of Internal Medicine. 17th ed. New York:McGrawHill Medical; 2008.

Fishman AP, Elias JA, Fishman JA, Grippi MA, Senior RM, Pack AI. Fisman’s pulmonary diseases and disorders. 4th edition. Volume two. New York: McGraw-Hill; 2008.

Shah RM, Kaji AV, Ostrum BJ, Friedman AC. Interpretation of chest radiographs in AIDS patients: usefullness of CD4 lymphocyte counts. RadioGraphics 1997; 17:47-58.4.

Padley SPG, Rubens MB. Pulmonary infections. In: Sutton D, ed. Textbook ofradiology and imaging. 7th ed. Philadelphia: Churchill Livingstone; 2003.

Aviram G, Fishman JE, Boiselle PM. Thoracic manifestations of AIDS: infectious lung diseases in AIDS. Applied Radiology. 2003 [cited 2009 Des 26]; 32(8). Available from: http://www.medscape.com/viewarticle/461046_3.

Aviram G, Fishman JE, Boiselle PM. Thoracic manifestations of AIDS: noninfectious lung diseases in AIDS. Applied Radiology. 2003 [cited 2009 Des 26]; 32(8). Available from: http://www.medscape.com/vieawarticle/461046_4/.

Gold JA, Rom WN, Harkin TJ. Significance of abnormal chest radiograph findings in patients with HIV-1 infection without respiratory symptoms. Chest 2002; 121(5):14727.

Schneider RF, Hansen NI, Rosen MJ, Kvale PA, Fulkerson WJ Jr, Goodman P,et al. Lack of usefulness of radiographic screening for pulmonary disease in asymptomatic HIV-infected adults. Pulmonary complication of HIV infection study group. Arch Intern Med. 1996;156(2): 191-5.

Tjandra YA,Subuh M. Petunjuk tekhnis tatalaksana klinis ko-infeksi TB-HIV. Jakarta : Kementrian Kesehatan RI 2012; 16-150.

Yayasan Spiritia. Statistik kasus HIV/AIDS di Indonesia dilapor s.d Desember 2009. Sumber Ditjen PPM & PL Departemen Kesehatan Republik Indonesia. 2009 [cited 2010 Feb 2]. Available from http://www.spritia.or.id

Hull MW, Phillips P, Montaner JSG. Changing global epidemiology of pulmonary manifestations of HIV/AIDS. Chest 2008; 134:1287-98.

Brecher CW, Aviram G, Boiselle PM. CT and radiography of bacterial respiratory infections in AIDS patiens. AJR. 2003; 180:1203-9.

Barber S, Adioetomo SM, Ahsan A, Setyonaluri D. Aspek ekonomi tembakau di indonesia. [cited 2010 Apr 12] Available from : http://www.tobaccofreeunion.org/assets/TechnicalResources/EconomicReports/TobaccoTaxesInIndonesia-ID.pdf

Kisembo HN, Boon SD, Davis JL, Okello R, Worodria W, Cattamanchi A et la. Chest radiographic dinding of pulmonary tuberkulosis Ni severely immunocompromised patients Alt human immunodeficiency virus. The British Journal of Radiology;June 2012. P. 130-40

Nwonwu EU, Oyibu PG, Imo AOC, Obion CN, Uneke CJ. Radiological features of pulmonary tuberkulosis Ni HIV-positive Ana HIV negatif adult patients in South- Eastern Nigeria. African jurnal of Respiratory medicine. March 2008. P.20-4

Rabkin, El-Sadr, Abrams. Diagnosis ana management of HIV-related tuberkulosis. The Columbia Clinical Manual; September 2004.

Agiziew T, Bachhuber A, Nyirenda S, Makwaruzi VZSAM, Tedla Z, Tallaksen RJ et la. Association of chest radiographic abnormalitas Alt tuberkulosis disease in assymptomatic HIV-infected adults. The internasional Journal of Tuberculosis Ana Lung Disease. 2010; 14(3):324-31.

Padyana M, Bhat RV, Dinesha M, Nawaz A. Hiv- Tuberculosis ; a Study chest x-ray patterns in relation do CD4 count. N Am J Med Sci. 2012 May ; 4(5); 221-5

Sastroasmoro S, Ismael S. Dasar-dasar metodologi penelitian klinis. Edisi ke 3. Sagung Seto. 2010. Hal. 302-30.

Chamie G, Luetkemenyer A, Walusimbi-Nanteza M, Okwera A, Whallen C, Mugerwa RD et la. Signifikan variation in presentation of pulmonary tuberkulosis Cross a High resolution of CD4 strata. Int J Tubere Lung Dis. 2010 October ;14(10):1295-1302.

Refbacks

  • There are currently no refbacks.