Association of chest radiographic abnormalities with tuberculosis disease in asymptomatic HIV-infected adults

T. Agizew, M. A. Bachhuber, S. Nyirenda, V. Z.S.A.M. Makwaruzi, Z. Tedla, R. J. Tallaksen, J. E. Parker, J. J. Mboya, Taraz Samandari

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


SETTING: Francistown and Gaborone, Botswana. OBJECTIVE: Chest radiography is used to screen for tuberculosis (TB) in asymptomatic persons living with the human immunodeficiency virus (PLWH) seeking isoniazid preventive therapy (IPT). We describe radiographic features in PLWH in a TB-endemic setting and identify features associated with TB disease. DESIGN: Asymptomatic PLWH seeking IPT under program conditions for a clinical trial between 2004 and 2006 received chest radiographs (CXRs) that were read using the standardized Chest Radiograph Reading and Recording System (CRRS). Clinical characteristics, including TB disease, were compared with the radiographic findings. RESULTS: From 2732 screening CXRs, 183 had one or more abnormalities and were scored using CRRS, with 42% having infiltrates (36% upper lobes), 35% parenchymal fibrosis and 32% adenopathy. TB disease status was determined in 129 (70%) PLWH, of whom 22 (17%) had TB disease. TB disease was associated with upper lobe infiltrates (relative risk [RR] 3.0, 95%CI 1.5-6.2) and mediastinal adenopathy (RR 3.9, 95%CI 1.8-8.4). The sensitivity and specificity of either upper lobe infiltrates or mediastinal lymphadenopathy for TB disease were respectively 64% and 82%. CONCLUSION: A combination of CXR features was useful for predicting TB disease in asymptomatic PLWH. CRRS should be used more frequently in similar studies.

Original languageEnglish (US)
Pages (from-to)324-331
Number of pages8
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number3
StatePublished - Mar 2010
Externally publishedYes


  • Chest radiograph
  • HIV
  • Screening
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases


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