[Radiological specifities of pulmonary tuberculosis in Congolese children: effect of HIV infection].

The purpose of this retrospective study was to identify special features of radiological lesions associated with pulmonary tuberculosis in HIV-infected children. A retrospective review was carried out on the files of children between the ages of 18 months and 15 years admitted to the University Hospital Centre in Brazzaville, Congo for pulmonary tuberculosis between January 1995 and December 2004. A total of 486 patients were analyzed including 174 (35.8%) HIV-infected patients (group 1) and 312 (64.2%) non-HIV-infected patients (group 2). Radiological findings in the two groups were compared. Parenchymal lesions were observed in a total of 474 patients including 172 (99.0%) in group 1 and 302 (96.8%) in group 2 (p> 0.05). The incidence of bilateral lesions (overall, 260 patients, i.e., 54.9%) was higher (p< 0.01) in HIV-infected patients than in non-HIV-infected patients: 66.1% (n=115) versus 46.5% (n=145) respectively. Most unilateral lesions (overall, 214 patients) involved the right lung but the difference between the two groups was not significant. The distribution of parenchymal lesions in function of radiological aspect was similar (p> 0.05) in two groups. The prevalence of mediastinal adenopathy (46.1% overall, i.e. 244 patients) was higher in HIV-infected children than in non-HIV-infected children: 75.9% (n=132) versus 46.4% (n=92) respectively. Pleural involvement (overall, 67 patients) was always associated with parenchymal lesions, and was found with similar frequency in the two groups. Our findings indicate that the presence of diffuse parenchymal lesions in both lungs is a characteristic radiological finding of pulmonary tuberculosis in HIV-infected children. Another specific feature of HIV/tuberculosis co-infection was high frequency of miliary and mediastinal adenopathy.