Terapevticheskii arkhiv · 2004
[Characteristics of tuberculosis running with HIV infection].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Shchelkanova A I, Kravchenko A V
Аннотация
AIM: To analyse social, clinical, x-ray and immunological features of tuberculosis (TB) in 117 patients from the Moscow region with concurrent HIV-infection.
MATERIAL AND METHODS: The patients were divided into 3 groups depending on the time of TB and HIV-infection detection in relation to each other. Group 1 patients (20.5%) had suffered from TB for 2 years before detection of HIV-infection, group 2 patients (51%) were diagnosed simultaneously for 1-2 years to have both diseases, group 3 patients (28%) had suffered from HIV-infection for 2 years before the diagnosis of TB.
RESULTS: It was established that the course of TB with associated HIV-infection depends not only on severity of immunodeficiency caused by HIV but also on characteristics of M. tuberculosis and social status of the patients. Most of TB/HIV patients were drug addicts, alcoholics, convicts. Unfavourable social status in the above patients, contact with TB (70%) and its realization in a penitentiary carry a high risk of drug-resistant TB. High prevalence of destructive TB forms (64%), among them large caverns were in 77%, may result from M. tuberculosis resistance to antituberculous drugs and unfavourable social status of the patients. Reduction of the number of CD4-cells lowers the ability to form caverns and fibrosis and promotes dissemination of M. tuberculosis bacteria with formation of inflammation foci in different organs and systems.
CONCLUSION: Four clinical models of TB/HIV onset and course are suggested.
MATERIAL AND METHODS: The patients were divided into 3 groups depending on the time of TB and HIV-infection detection in relation to each other. Group 1 patients (20.5%) had suffered from TB for 2 years before detection of HIV-infection, group 2 patients (51%) were diagnosed simultaneously for 1-2 years to have both diseases, group 3 patients (28%) had suffered from HIV-infection for 2 years before the diagnosis of TB.
RESULTS: It was established that the course of TB with associated HIV-infection depends not only on severity of immunodeficiency caused by HIV but also on characteristics of M. tuberculosis and social status of the patients. Most of TB/HIV patients were drug addicts, alcoholics, convicts. Unfavourable social status in the above patients, contact with TB (70%) and its realization in a penitentiary carry a high risk of drug-resistant TB. High prevalence of destructive TB forms (64%), among them large caverns were in 77%, may result from M. tuberculosis resistance to antituberculous drugs and unfavourable social status of the patients. Reduction of the number of CD4-cells lowers the ability to form caverns and fibrosis and promotes dissemination of M. tuberculosis bacteria with formation of inflammation foci in different organs and systems.
CONCLUSION: Four clinical models of TB/HIV onset and course are suggested.