Tuberculosis in patients with hiv infection in a therapeutic hospital in a region with high hiv prevalence

Objective. To analyze the role and character of tuberculosis (TB) among all respiratory diseases in HIV-infected patients treated in a therapeutic hospital Patients and methods. This longitudinal retrospective study included all consecutive HIV-positive patients with respiratory diseases (n = 185) treated in the Therapeutic Department of the City Hospital No 2 in Novokuznetsk in 2017–2018. Results. TB was diagnosed in 50 HIV-infected patients (27.0%) admitted to hospital. Median CD4 count was 124 cells/µL. Only 14.3% of patients were adherent to antiretroviral therapy. Sputum smear microscopy in TB dispensary was positive twice as often as in the therapeutic hospital (54.4% vs 23.4%). Abdominal lymphadenopathy was detected in 52.8% of patients examined, regardless of the pulmonary lesion pattern (p >0.05); 25.0% of patients were diagnosed with endobronchial TB. The main radiological syndromes of TB in the HIV-infected population included dissemination (52.0%), infiltration (26.0%), and intrathoracic lymphadenopathy (10.0%). Pleural lesions were identified in 28% of participants with TB and HIV coinfection. Conclusion. TB was the only cause of focal dissemination (100.0%, p < 0.001), while pleural lesions and intrathoracic lymphadenopathy were significantly more common in TB patients than in individuals with non-tuberculosis diseases (11.6% and 0.8%, respectively, p < 0.05). Hospital mortality rate among TB patients in a therapeutic hospital was 8.0%. © 2020, Dynasty Publishing House. All rights reserved.

Authors
Viktorova I.B. 1 , Zimina V.N. 2 , Khanin A.L. 3 , Dadyka I.V.4 , Goryaeva M.O.5 , Solovyova A.V.1
Publisher
Dynasty Publishing House
Number of issue
4
Language
Russian
Pages
74-79
Status
Published
Volume
18
Year
2020
Organizations
  • 1 Phthisiopulmonary Department, Novokuznetsk State Medical Institute of Postgraduate Education, Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia, 5 Stroiteley ave., Novokuznetsk, 654005, Russian Federation
  • 2 Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Peoples' Friendship University of Russia (RUDN), 6 Miklukho-Maklay str., Moscow, 117198, Russian Federation
  • 3 Phthisiopulmonary Department, Novokuznetsk state Institute for Further Training of Physicians – Branch Campus, Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, 5 Stroiteley ave., Novokuznetsk, 654005, Russian Federation
  • 4 Therapeutic department, Novokuznetsk branch of the State Budgetary Healthcare Institution of the Kemerovo Region “Academician L.S.Barbarash Kemerovo Regional Clinical Cardiology Dispensary”, 35 Kuznetsov str., Novokuznetsk, 654005, Russian Federation
  • 5 Novokuznetsk branch of the State Budgetary Healthcare Institution, Kemerovo Region “Academician L.S.Barbarash Kemerovo Regional Clinical Cardiology Dispensary”, 35 Kuznetsov str., Novokuznetsk, 654005, Russian Federation
Keywords
HIV infection; Immunosuppression; Tuberculosis
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