[Clinical and radiological features of tuberculosis during HIV infection in Libreville, Gabon]. / Aspects cliniques et radiologiques de la tuberculose au cours de l'infection par le VIH à Libreville, Gabon.

OBJECTIVE: The purpose of this report is to describe the clinical and radiological features of tuberculosis during HIV infection. MATERIALS AND METHODS: This retrospective comparative study was based on review of patients treated between 2006 and 2010 in the Department of Medicine of the Military Hospital in Libreville, Gabon. A total of 156 patients with all types of tuberculosis were included, i.e., a study group of 78 tuberculosis patients co-infected with HIV and a control group of 78 seronegative tuberculosis patients. Analysis was carried out on demographic, clinical and radiological data. RESULTS. Most patients in both groups were male. Mean patient age was 37.1 +/- 10.3 in the seropositive group and 29.5 +/- 11.5 in the seronegative group. Deterioration in general health was quantitatively higher in the seropositive group. Tuberculosis was confined to the lungs in 41% of patients co-infected with HIV and 55% of seronegative patients. Chest x-rays showed more extensive cavitation in seronegative patients. Mixed pulmonary and extrapulmonary disease was observed in 20.5% of seropositive patients and 10.3% of seronegative patients. The CD4 lymphocyte rate was not statistically different between patients with pulmonary versus extrapulmonary tuberculosis. CONCLUSION. Tuberculosis during HIV infection often has an atypical or banal clinical presentation. Radiological findings may be non-distinctive or even normal. For this reason, diagnosis of tuberculosis may be difficult.