{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T17:04:58Z","timestamp":1763399098673},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2002,1,6]],"date-time":"2002-01-06T00:00:00Z","timestamp":1010275200000},"content-version":"vor","delay-in-days":1466,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[1998,1]]},"abstract":"<jats:p> <jats:sc>objective<\/jats:sc>\n          \u2002\n          \u2002To elucidate the relationship between HIV, CD4<jats:sup>1<\/jats:sup> count and pleural TB.<jats:sc>method<\/jats:sc>\u2002\u2002In a prospective study, 94 patients presenting at two large Harare hospitals with clinically suspected pleural TB were enrolled over a 10\u2010month period. All underwent standardized evaluation, closed pleural aspiration and biopsy. Patients receiving directly observed anti\u2010TB therapy were followed\u2010up.<jats:sc>results<\/jats:sc>\u2002\u2002Pleural TB was diagnosed in 90 individuals (median age 33 years; range 18\u201065; 64 males); the seroprevalence of HIV was 85%. HIV\u2010positive patients were older than HIV\u2010negative individuals (median age 33 <jats:italic>vs<\/jats:italic> 23 years, <jats:italic>P<\/jats:italic>= 0.013) and had a significantly lower median CD4<jats:sup>1<\/jats:sup> count (191 <jats:italic>vs<\/jats:italic> 1106 \u00d7 10<jats:sup>6<\/jats:sup>\/l respectively, <jats:italic>P<\/jats:italic>= 0.004). A CD4<jats:sup>1<\/jats:sup> count of &lt;200 \u00d7 10<jats:sup>6<\/jats:sup>\/l was associated with a length of illness &gt;30 days (65% <jats:italic>vs<\/jats:italic> 37%; <jats:italic>P<\/jats:italic>= 0.05), a positive pleural fluid smear (37% <jats:italic>vs<\/jats:italic> 0%; <jats:italic>P<\/jats:italic>= 0.0006) and a positive pleural biopsy Ziehl\u2010Neelsen stain (35% <jats:italic>vs<\/jats:italic> 7%; <jats:italic>P<\/jats:italic>= 0.021). However, a relationship between CD4<jats:sup>1<\/jats:sup> count and either pleural granuloma formation or radiological evidence of disseminated disease was not observed.<jats:sc>conclusion<\/jats:sc>\u2002\u2002In sub\u2010Saharan Africa, TB pleural effusions have become associated with older age, a chronic onset, and an increased mycobacterial load. These data emphasize the complex relationship between pleural TB, HIV infection and a low CD4<jats:sup>1<\/jats:sup> count.<\/jats:p>","DOI":"10.1046\/j.1365-3156.1998.00167.x","type":"journal-article","created":{"date-parts":[[2003,3,12]],"date-time":"2003-03-12T21:30:37Z","timestamp":1047504637000},"page":"14-20","source":"Crossref","is-referenced-by-count":42,"title":["Pleural tuberculosis in Harare, Zimbabwe: the relationship between human immunodeficiency virus, CD4 lymphocyte count, granuloma formation and disseminated disease"],"prefix":"10.1111","volume":"3","author":[{"given":"R. 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