pulmonary tuberculosis in patients with hiv/aids in iran

background: pulmonary tuberculosis is still the most common form of tuberculosis in hiv infected patients having differ­ent presentations according to the degree of immunosuppression. this study appraised the impact of hiv infection on clini­cal, laboratory and radiological presentations of tuberculosis. methods: the clinical, laboratory and radiological presentations of pulmonary tb in 56 hiv-infected patients were com­pared with 56 individually sex and age matched hiv-seronegative ones, admitted to imam hospital in tehran (1999-2006) us­ing paired t -test in a case control study.   results: all cases and the controls were male. fever was found in 83.9% of the hiv positive patients compared to 80% of the hiv negative ones. cough was the most common clinical finding in the hiv negative group (89.3% vs. 82.1% in hiv posi­tive group). among radiological features, cavitary lesions, upper lobe and bilateral pulmonary involvement were ob­served significantly less often in the hiv-infected group. on the contrary, lymphadenopathy was just present in the hiv posi­tive group in this series of patients (12%) and primary pattern tuberculosis was more common, as well (71% vs. 39%, p = 0.02). the tuberculin test was reactive in 29% of the hiv/tb patients. conclusion: the coexistence of both infections alters the picture of tuberculosis in many aspects and should be taken into ac­count when considering a diagnosis of hiv infection and its potential for tb co-infection, and vice-versa.