Influence of HIV status on pathological changes in tuberculous pleuritis

Tuber Lung Dis. 1994 Jun;75(3):195-8. doi: 10.1016/0962-8479(94)90007-8.

Abstract

Setting: The AIDS epidemic has been associated with an increase in the incidence of tuberculosis, pulmonary or extrapulmonary.

Objective: To compare morphological changes in tuberculous pleurisy, and response to therapy in HIV-positive and-negative patients.

Design: 57 consecutive patients admitted between January and August 1991 with tuberculous pleurisy who were biopsy proven were studied. 36 were HIV-positive and 21 were HIV-negative.

Results: 3 types of morphological changes were observed: reactive, hyporeactive and non-reactive. Hypo- and non-reactive patterns were found in 14 of 36 HIV-positive patients but in only 2 of 21 HIV-negative patients (P < 0.02). In the HIV-positive group, 10 of the 14 with hypo- or non-reactive patterns had other HIV-related complications, compared to 6 of 22 with reactive patterns (P < 0.01). When HIV-positive patients' response to therapy was investigated, 2 of 5 patients with hypo- and non-reactive patterns improved compared to all 13 with reactive patterns (P < 0.05).

Conclusion: A hypo- or non-reactive tissue reaction in HIV-positive patients with tuberculous pleuritis seems to indicate a less favourable prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / pathology*
  • Adult
  • Biopsy
  • Female
  • Follow-Up Studies
  • HIV Seronegativity
  • HIV Seropositivity / pathology
  • Humans
  • Male
  • Middle Aged
  • Necrosis
  • Pleura / pathology*
  • Prospective Studies
  • Tuberculoma / pathology
  • Tuberculosis, Pleural / drug therapy
  • Tuberculosis, Pleural / pathology*