APPG Entrance Preparations | Tuberculosis in HIV positive individual

Which statement is false regarding Tuberculosis in HIV positive individual

A. Frequent negative sputum smear. 

B. False negative tuberculin test result
C. Extra pulmonary tuberculosis more common. 
D. Cavitating lesions in lungs as shown by chest X-ray.

Ans. D.  Cavitating lesions in lungs as shown by chest X-ray.

In early part of HIV infection with high CD4 count, the clinical manifestations are more similar to non HIV TB patient. But in latter part of HIV infection when CD4 count is low, TB patient more commonly present with atypical features of pulmonary TB and also features of extra pulmonary TB. In X-ray chest- lower zone infiltration, bilateral interstitial infiltrate, mediastinal hilar lymph gland enlargement and nodular lesions are commonly seen. Cavitary lesion and upper zone infiltration are less common. Extra pulmonary TB are more common in HIV - TB Co infected patient. Sputum smear examination show negative for AFB because of less cavitation in HIV —TB co infected patients. False negative Tuberculin test result is due to decreased immune response in advance I-BY infection