OBJECTIVE To explore the epidemiological characteristics of tuberculosis complicated with human immunodeficiency virus (HIV) infection and their relationships with T helper lymphocyte (Th) 1/Th2 related factors.

METHODS From May 2022 to Feb. 2024, 118 patients with tuberculosis combined with HIV infection admitted to Guiyang Public Health Rescue Center were selected as the study group. The patients were divided into group A (> 1.0E3 cp/ml < 1.0E4 cp/ml) with 31 cases, group B (≥1.0E4 cp/ml < 1.0E5 cp/ml) with 36 cases, group C (≥1.0E5 cp/ml) with 51 cases according to viral load. Another 120 patients with simple pulmonary tuberculosis were selected as control group. The characteristics of epidemic cases, imaging CT features and levels of Th1/Th2 related cytokines including interleukin-2 (IL-2), tumor necrosis factor-α (TNF-α), interferon γ (IFN-γ), IL-4, IL-6 and IL-10were compared between the study group and the control group, and the relationship between viral load and atypical CT manifestations of tuberculosis were analyzed.

RESULTS There were significant differences in educational level, occupational status, intravenous drug use history and baseline CD4 values between the two groups (P < 0.05). The study group showed higher rates of CT manifestations such as multiple pulmonary fields and segments exudation, extrapulmonary tuberculosis, multiple cavities, intrathoracic lymph node enlargement, multiple nodules, and diffuse miliary shadow than the control group, conversely, the frequencies of single cavity, calcification and speckle shadow in the study group were lower than those in the control group (P < 0.05). Compared with the control group, the levels of IL-2, TNF-α and IFN-γ in the study group were low, while the levels of IL-4, IL-6 and IL-10 were high (P < 0.05). With the increase of viral load, the rates of atypical CT tuberculosis were also increased (P < 0.05).

CONCLUSION The CT imaging findings in patients with tuberculosis combined with HIV infection are atypical and Th1/Th2 related cytokines are abnormal, and the chest CT manifestations are associated with high viral load.