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. 2011 Mar;66(3):257-63.
doi: 10.1016/j.crad.2010.10.009. Epub 2010 Dec 23.

Chest radiography patterns in 75 adolescents with vertically-acquired human immunodeficiency virus (HIV) infection

S R Desai  1 , S J Copley, R D Barker, C M Elston, R F Miller, A U Wells, S Munyati, K Nathoo, E L Corbett, R A Ferrand
Affiliations

Chest radiography patterns in 75 adolescents with vertically-acquired human immunodeficiency virus (HIV) infection

S R Desai et al. Clin Radiol. 2011 Mar.

Abstract

Aim: To evaluate lung disease on chest radiography (CR), the relative frequency of CR abnormalities, and their clinical correlates in adolescents with vertically-acquired human immunodeficiency virus (HIV) infection.

Materials and methods: CRs of 75 patients [59 inpatients (33 males; mean age 13.7±2.3 years) and 16 outpatients (eight males; mean age 14.1±2.1 years)] were retrospectively reviewed by three independent observers. The overall extent of disease (to the nearest 5%), its distribution, and the proportional extents (totalling 100%) of different radiographic patterns (including ring/tramline opacities and consolidation) were quantified. CR features and clinical data were compared.

Results: CRs were abnormal in 51/75 (68%) with "extensive" disease in 38/51 (74%). Ring/tramline opacities and consolidation predominated (i.e., proportional extent >50%) in 26 and 21 patients, respectively. Consolidation was significantly more common in patients hospitalized primarily for a respiratory illness than patients hospitalized for a non-respiratory illness or in outpatients (p<0.005, χ(2) for trend); by contrast, ring/tramline opacities did not differ in prevalence across the groups. On stepwise logistic regression, predominant consolidation was associated with progressive dyspnoea [odds ratio (OR) 5.60; 95% confidence intervals (CI): 1.60, 20.1; p<0.01] and was associated with a primary respiratory cause for hospital admission (OR: 22.0; CI: 2.7, 181.1; p<0.005). Ring/tramline opacities were equally prevalent in patients with and without chronic symptoms and in those admitted to hospital with respiratory and non-respiratory illness.

Conclusion: In HIV-infected adolescents, evaluated in secondary practice, CR abnormalities are prevalent. The presence of ring/tramline opacities, believed to reflect chronic airway disease, is not linked chronic respiratory symptoms.

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Figures

Figure 1
Figure 1
CRs in two patients with vertically-acquired HIV infection. (a) 16-year-old male patient with rings (arrows) and tramline opacities (arrowheads) in both lungs, principally in the mid- and upper zones, and (b) targeted image of the right lower zone showing ring opacities (taken to indicate thick-walled, bronchiectatic airways).
Figure 2
Figure 2
CR in a 14-year-old HIV-positive adolescent with predominant and patchy bilateral consolidation.
See this image and copyright information in PMC

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