Login Register Cart 0
Generic placeholder image

Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Distribution and Characteristics of Intrathoracic Lymphadenopathy in TB/HIV Co-Infection

Author(s): Payam Mehrian, Abtin Doroudinia*, Moghadaseh Shams and Niloufar Alizadeh

Volume 19, Issue 4, 2019

Page: [414 - 420] Pages: 7

DOI: 10.2174/1871526518666181016111142

Price: $65

Abstract

Background: Intrathoracic Lymphadenopathy (ITLN) in Human Immunodeficiency Virus (HIV) infected patients may have various etiologies and prognoses. Etiologies of ITLN can be distinguished based on the distribution of enlarged lymph nodes. Sometimes tuberculosis (TB) is the first sign of underlying HIV infection.

Objectives: We sought to determine ITLN distribution and associated pulmonary findings in TB/HIV co-infection using Computed Tomography (CT) scan.

Methods: In this retrospective, observational, cross-sectional study, chest CT scans of 52 patients with TB/HIV co-infection were assessed for enlarged intrathoracic lymph nodes (>10 mm in short axis diameter), lymphadenopathy (LAP) distribution, calcification, conglomeration, the presence of hypodense center and associated pulmonary abnormalities. LAP distribution was compared in TB/HIV co-infection with isolated TB infection.

Results: Mediastinal and/or hilar LAP were seen in 53.8% of TB/HIV co-infection patients. In all cases, LAP was multistational. The most frequent stations were right lower paratracheal and subcarinal stations. Lymph node conglomeration, hypodense center and calcification were noted in 25%, 21.4% and 3.5% of patients, respectively. LAP distribution was the same as that in patients with isolated TB infection except for the right hilar, right upper paratracheal and prevascular stations. All patients with mediastinal and/or hilar adenopathy had associated pulmonary abnormalities.

Conclusion: All patients with TB/HIV co-infection and mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Superior mediastinal lymph nodes were less commonly affected in TB/HIV co-infection than isolated TB.

Keywords: Intrathoracic lymphadenopathy, Tuberculosis, HIV, mediastinal, hilar, lymph node map, CT scan.

Graphical Abstract

[1]
Bennett, J.E. Mandell, Douglas, and Bennett'sPrinciples and Practice of InfectiousDiseases. 8th ed., Elsevier, 2015. Chapter 120. Global perspectives on humanimmunodeficiency virus infection and acquiredimmunodeficiency syndrome. Peter piot, helenaLegido- quigley. PP: 1469.
[2]
Fettig, J.; Swaminathan, M.; Murrill, C.S.; Kaplan, J.E. Global epidemiology of HIV. Infect. Dis. Clin. North Am., 2014, 28(3), 323-337.
[http://dx.doi.org/10.1016/j.idc.2014.05.001] [PMID: 25151559]
[3]
Fact sheets- Latest statistics on the status of the AIDS epidemic. http://www.unaids.org/en/resources/documents/2015/20150714_factsheet; 52Accessed on September, 15th, 2017
[4]
Goldman, Lee. Goldman-Cecil Medicine. 25th ed; vol. 2, Elsevier Saunders, 2015. Chapter 391. Pulmonary manifestations of human immunodeficiency virus. PP: 2311.
[5]
Trinh, Q.M.; Nguyen, H.L.; Do, T.N.; Nguyen, V.N.; Nguyen, B.H.; Nguyen, T.V.; Sintchenko, V.; Marais, B.J. Tuberculosis and HIV co-infection in Vietnam. Int. J. Infect. Dis., 2016, 46(45)(Suppl. 1), 56-60.
[http://dx.doi.org/10.1016/j.ijid.2016.03.021] [PMID: 27044521]
[6]
Kwan, C.K.; Ernst, J.D. HIV and tuberculosis: a deadly human syndemic. Clin. Microbiol. Rev., 2011, 24(2), 351-376.
[http://dx.doi.org/10.1128/CMR.00042-10] [PMID: 21482729]
[7]
Kasper, Dennis.L. Harrison's Principles Int. Med. 19th; ed, vol. 3, Mc Graw Hill Education, 2015. Section 14, infections due to human immunodeficiency virus and other human retroviruses. Dan L.Longo, AnthonynS.Fauci PP:1254
[8]
Wells, C.D.; Cegielski, J.P.; Nelson, L.J.; Laserson, K.F.; Holtz, T.H.; Finlay, A.; Castro, K.G.; Weyer, K. HIV infection and multidrug-resistant tuberculosis: the perfect storm. J. Infect. Dis., 2007, 196(196)(Suppl. 1), S86-S107.
[http://dx.doi.org/10.1086/518665] [PMID: 17624830]
[9]
Smaoui, S.; Mezghanni, M.A.; Hammami, B.; Zalila, N.; Marouane, C.; Kammoun, S.; Ghorbel, A.; Ben Jemaa, M.; Messadi-Akrout, F. Tuberculosis lymphadenitis in a southeastern region in Tunisia: Epidemiology, clinical features, diagnosis and treatment. Int. J. Mycobacteriol., 2015, 4(3), 196-201.
[http://dx.doi.org/10.1016/j.ijmyco.2015.04.004] [PMID: 27649866]
[10]
Jasmer, R.M.; Gotway, M.B.; Creasman, J.M.; Webb, W.R.; Edinburgh, K.J.; Huang, L. Clinical and radiographic predictors of the etiology of computed tomography-diagnosed intrathoracic lymphadenopathy in HIV-infected patients. J. Acquir. Immune Defic. Syndr., 2002, 31(3), 291-298.
[http://dx.doi.org/10.1097/00126334-200211010-00004] [PMID: 12439204]
[11]
Allen, C.M.; Al-Jahdali, H.H.; Irion, K.L.; Al Ghanem, S.; Gouda, A.; Khan, A.N. Imaging lung manifestations of HIV/AIDS. Ann. Thorac. Med., 2010, 5(4), 201-216.
[http://dx.doi.org/10.4103/1817-1737.69106] [PMID: 20981180]
[12]
Alçada, J.; Taylor, M.N.; Shaw, P.J.; Janes, S.M.; Navani, N.; Miller, R.F. High prevalence of malignancy in HIV-positive patients with mediastinal lymphadenopathy: a study in the era of antiretroviral therapy. Respirology, 2014, 19(3), 339-345.
[http://dx.doi.org/10.1111/resp.12241] [PMID: 24471994]
[13]
Tang, S.S.; Yang, Z.G.; Deng, W.; Shao, H.; Chen, J.; Wen, L.Y. Differentiation between tuberculosis and lymphoma in mediastinal lymph nodes: Evaluation with contrast-enhanced MDCT. Clin. Radiol., 2012, 67(9), 877-883.
[http://dx.doi.org/10.1016/j.crad.2012.02.006] [PMID: 22483945]
[14]
Mehrian, P.; Moghaddam, A.M.; Tavakkol, E.; Amini, A.; Moghimi, M.; Kabir, A.; Velayati, A. Determining the lymphadenopathy characteristics of the mediastinum in lung CT scan of children with tuberculosis. Int. J. Mycobacteriol., 2016, 5(3), 306-312.
[http://dx.doi.org/10.1016/j.ijmyco.2016.06.015] [PMID: 27847015]
[15]
Mehrian, P.; Ebrahimzadeh, S.A. Differentiation between sarcoidosis and Hodgkin’s lymphoma based on mediastinal lymph node involvement pattern: Evaluation using spiral CT scan. Pol. J. Radiol., 2013, 78(3), 15-20.
[http://dx.doi.org/10.12659/PJR.889056] [PMID: 24115955]
[16]
Haramati, L.B.; Jenny-Avital, E.R.; Alterman, D.D. Effect of HIV status on chest radiographic and CT findings in patients with tuberculosis. Clin. Radiol., 1997, 52(1), 31-35.
[http://dx.doi.org/10.1016/S0009-9260(97)80302-9] [PMID: 9022577]
[17]
Andronikou, S.; Joseph, E.; Lucas, S. CT scanning for the detection of tuberculous mediastinal and hilar lymphadenopathy in children. Pediatr. Radiol., 2004, 34(3), 232-236.
[18]
Ayed, A.K.; Behbehani, N.A. Diagnosis and treatment of isolated tuberculous mediastinal lymphadenopathy in adults. Eur. J. Surg., 2001, 167(5), 334-338.
[http://dx.doi.org/10.1080/110241501750215186] [PMID: 11419546]
[19]
Baran, R.; Tor, M.; Tahaoğlu, K.; Ozvaran, K.; Kir, A.; Kizkin, O.; Türker, H. Intrathoracic tuberculous lymphadenopathy: clinical and bronchoscopic features in 17 adults without parenchymal lesions. Thorax, 1996, 51(1), 87-89.
[http://dx.doi.org/10.1136/thx.51.1.87] [PMID: 8658377]
[20]
Im, J.G.; Song, K.S.; Kang, H.S.; Park, J.H.; Yeon, K.M.; Han, M.C.; Kim, C.W. Mediastinal tuberculous lymphadenitis: CT manifestations. Radiology, 1987, 164(1), 115-119.
[http://dx.doi.org/10.1148/radiology.164.1.3588896] [PMID: 3588896]
[21]
Rajeswaran, G.; Becker, J.L.; Michailidis, C.; Pozniak, A.L.; Padley, S.P. The radiology of IRIS (immune reconstitution inflammatory syndrome) in patients with mycobacterial tuberculosis and HIV co-infection: Appearances in 11 patients. Clin. Radiol., 2006, 61(10), 833-843.
[http://dx.doi.org/10.1016/j.crad.2006.04.007] [PMID: 16978978]
[22]
Pastores, S.M.; Naidich, D.P.; Aranda, C.P.; McGuinnes, G.; Rom, W.N. Intrathoracic adenopathy associated with pulmonary tuberculosis in patients with human immunodeficiency virus infection. Chest, 1993, 103(5), 1433-1437.
[http://dx.doi.org/10.1378/chest.103.5.1433] [PMID: 8486023]
[23]
Huang, L.; Crothers, K. HIV-associated opportunistic pneumonias. Respirology, 2009, 14(4), 474-485.
[http://dx.doi.org/10.1111/j.1440-1843.2009.01534.x] [PMID: 19645867]
[24]
Hegde, S.; Rithesh, K.B.; Baroudi, K.; Umar, D. Tuberculous lymphadenitis: early diagnosis and intervention. J. Int. Oral Health, 2014, 6(6), 96-98.
[PMID: 25628495]
[25]
Leung, A.N.; Brauner, M.W.; Gamsu, G.; Mlika-Cabanne, N.; Ben Romdhane, H.; Carette, M.F.; Grenier, P. Pulmonary tuberculosis: comparison of CT findings in HIV-seropositive and HIV-seronegative patients. Radiology, 1996, 198(3), 687-691.
[http://dx.doi.org/10.1148/radiology.198.3.8628855] [PMID: 8628855]
[26]
San, K.E.; Muhamad, M. Pulmonary Tuberculosis in HIV Infection: The Relationship of the Radiographic Appearance to CD4 T-Lymphocytes Count. Malays. J. Med. Sci., 2001, 8(1), 34-40.
[PMID: 22973154]
[27]
Radiographic Manifestations in TB/HIV Patients. Tanaffos, 2004, 3(9), 33-39.
[28]
Patel, A.K.; Thakrar, S.J.; Ghanchi, F.D. Clinical and laboratory profile of patients with TB/HIV coinfection: A case series of 50 patients. Lung India, 2011, 28(2), 93-96.
[http://dx.doi.org/10.4103/0970-2113.80316] [PMID: 21712939]
[29]
Breen, R.A.M.; Smith, C.J.; Bettinson, H.; Dart, S.; Bannister, B.; Johnson, M.A.; Lipman, M.C. Paradoxical reactions during tuberculosis treatment in patients with and without HIV co-infection. Thorax, 2004, 59(8), 704-707.
[http://dx.doi.org/10.1136/thx.2003.019224] [PMID: 15282393]
[30]
Djoba Siawaya, J.F.; Ruhwald, M.; Eugen-Olsen, J.; Walzl, G. Correlates for disease progression and prognosis during concurrent HIV/TB infection. Int. J. Infect. Dis., 2007, 11(4), 289-299.
[http://dx.doi.org/10.1016/j.ijid.2007.02.001] [PMID: 17446108]

Rights & Permissions Print Cite
Article Metrics
18
1
© 2024 Bentham Science Publishers | Privacy Policy