Prospective evaluation of lung ultrasound in comparison to radiography and CT for detection of HIV-related lung diseases. Ultrasound examinations in HIV-positive patients were evaluated by three raters, available conventional imaging was evaluated by another rater. Results were compared to each other and to the definite diagnosis, interrater reliability was calculated for each finding.
80 HIV-positive patients received lung ultrasound examinations, 74 received conventional imaging. The overall sensitivity was 97.5% for CT, 90.7% for ultrasound and 78.1% for radiography. The most common diagnoses were Pneumocystis jirovecii pneumonia (21 cases) and bacterial pneumonia (17 cases). The most frequent and sensitive ultrasonographic findings were interstitial abnormalities indicated by B-Lines, independent of the etiology. Interrater reliability was high for interstitial abnormalities (ICC=0.82). The interrater reliability for consolidations and effusion increased during the study (r=0.88 and 0.37, respectively).
Ultrasound is a fast, reliable, and sensitive point-of-care tool particularly in detecting interstitial lung disease, which is common in HIV-associated illness. It does not effectively discriminate between different etiologies. A longer learning period might be required to reliably identify consolidations and effusions.

Copyright © 2021. Published by Elsevier Ltd.