Comparative Evaluation Of Chest Radiographic Patterns of Pulmonary Tuberculosis among HIV Sero-Positive and HIV Sero-Negative Adults in Delta State

Abstract

Introduction: Pulmonary tuberculosis (PTB) remains a major global health challenge, causing ill-health in nearly ten million people annually and ranking among the top ten causes of death worldwide. Sub-Saharan Africa contributes about one-quarter of the global burden, with Nigeria being a major contributor. The risk of developing PTB is significantly higher in individuals infected with Human Immunodeficiency Virus (HIV), and the chest radiographic patterns of PTB are known to be influenced by the degree of immunosuppression associated with HIV co-infection.

Objective: This study aimed to describe the chest radiographic patterns of PTB in HIV sero-positive patients and compare them with age and sex-matched HIV sero-negative adults in Delta State, Nigeria.

Method: This cross-sectional comparative study was conducted among 110 HIV sero-positive and 110 HIV sero-negative PTB patients. Diagnosis was based on positivity of sputum smear and Gene Xpert laboratory tests, together with chest radiographic findings. The data was collected using researcher-administered questionnaires. Chest radiographs of all the participants were assessed for typical and atypical PTB patterns. Data analysis was performed using SPSS version 22.0 with statistical significance set at p ≤ 0.05.

Results: The study findings showed that consolidation, fibrosis, and cavitations were more frequent among the HIV sero-negative patients, with consolidation being statistically significant (27.3% vs 43.6%, p=0.011). Conversely, HIV sero-positive patients had higher frequencies of hilar lymphadenopathy, pleural effusion, miliary opacities, and normal radiographs, with hilar lymphadenopathy (35.5% vs 21.8%, p=0.025) and miliary changes (11.8% vs 1.8%, p=0.003) being significant.

Conclusion: Atypical radiographic patterns were more common in HIV sero-positive patients, underscoring the role of immunosuppression in determining PTB presentation.