Abstract
The problem of tuberculosis with concurrent HIV infection is now becoming increasingly important. It is necessary to determine predictors of a lethal outcome from TB/HIV co-infection for timely selection of the optimal tactics for managing patients and reducing the number of unfavorable outcomes. Objective: to identify significant risk factors of hospital mortality from TB/HIV co-infection among patients in penitentiary institutions. Subjects and methods . For statistical data processing, machine learning methods were used based on the optimal splitting of feature space. To determine the significance coefficients of the identified risk factors, the artificial neural network method was used. Results. The predictive factors of mortality of a tuberculosis patient with concurrent HIV infection undergoing inpatient treatment were identified. The major ones were the following: presence of active HIV associated diseases, CD4 count below 88 cell/mcl, viral load exceeding 595,892.5 copies/mcl, such clinical forms of tuberculosis as bilateral infiltrative tuberculosis with lesion in more than two lobes, disseminated, miliary, fibrous-cavernous tuberculosis, caseous pneumonia, extrapulmonary tuberculosis, and arrhythmia.
Highlights
Проблема туберкулеза, протекающего на фоне ВИЧ-инфекции, в настоящее время приобретает все бóльшую актуальность
The major ones were the following: presence of active HIV associated diseases, CD4 count below 88 cell/mcl, viral load exceeding 595,892.5 copies/mcl, such clinical forms of tuberculosis as bilateral infiltrative tuberculosis with lesion in more than two lobes, disseminated, miliary, fibrous-cavernous tuberculosis, caseous pneumonia, extrapulmonary tuberculosis, and arrhythmia
Risk factors of hospital mortality in patients with TB/HIV co-infection confined in the penitentiary system
Summary
The predictive factors of mortality of a tuberculosis patient with concurrent HIV infection undergoing inpatient treatment were identified. For citations: Vostroknutov M.E., Dyuzheva E.V., Kuznetsova А.V., Senko O.V. Risk factors of hospital mortality in patients with TB/HIV co-infection confined in the penitentiary system. Tuberculosis and Lung Diseases, 2019, Vol 97, no. В учреждениях уголовно-исполнительной системы (УИС) клиническое течение сочетанной коинфекции туберкулез и ВИЧ-инфекция (ТБ/ВИЧ-и) осложняется спецификой условий содержания осужденных, воздействием пенитенциарных стрессоров, наличием преморбидного фона [12]. Tuberculosis and Lung Diseases, Vol 97, No 7, 2019 циарной системе встречается качественно новый вид этой сочетанной патологии, крайне агрессивно протекающей на фоне неблагоприятного преморбидного состояния [12]. В связи с этим своевременный прогноз неблагоприятного исхода коинфекции ТБ/ВИЧ-и составляет одно из направлений профилактики госпитальной летальности в медицинских учреждениях УИС. Цель исследования: определение значимых факторов риска госпитальной летальности от сочетанной патологии ТБ/ВИЧ-и среди пациентов медицинских учреждений УИС
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