Low yield of chest radiography in screening for active pulmonary tuberculosis in HIV-infected patients in Hong Kong

This study assessed the usefulness of routine chest radiography for detecting active pulmonary tuberculosis in persons infected with human immunodeficiency virus (HIV) without suggestive symptoms in Hong Kong. Tuberculosis is common in this locality and tuberculosis/HIV co-infection has been a frequent and significant problem. Records of patients attending the largest HIV clinic were reviewed. Three hundred and eleven routine chest radiographs were performed among 191 HIV-infected patients with a total follow-up period of 792 person years. Of the 22 routine chest radiographs that had abnormalities in the lungs or hilar region, only one had led to the diagnosis of pulmonary tuberculosis. No patient with a normal chest radiograph was diagnosed to have tuberculosis within the following 2 months. The low yield (0.32%) suggests that routine chest radiography is not useful in screening for active pulmonary tuberculosis in asymptomatic HIV-infected patients even in a locality where the tuberculosis rate is high.