What are the clinical features of TB and what type of TB Is more commonly seen In HIV-positive Individuals?
As HIV infection progresses, CD4+ lymphocytes decline in number and function. Therefore, the immune system is less able to prevent the growth and local spread of M. tuberculosis. As a result, disseminated and extra-pulmonary disease is more commonly seen. Nevertheless, pulmonary TB is still the most common form of TB even in HIV-infected patients. Many studies reveal that pulmonary involvement occurs in 70-90% of all patients with TB. 1. Pulmonary TB The presentation of pulmonary TB depends on the degree of immunosuppression. The table below shows how the clinical features, results of sputum smear, and chest X-ray appearance differs in early and late HIV infection. In advanced HIV infection, the presence of many opportunistic infectious affecting the lungs may cause difficulties in the diagnosis of TB. The occurrence of hilarand/or mediastinal adenopathy by chest X-ray can also suggest the diagnosis of TB in an HIV-infected patient.
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