АНАЛИЗ ПРИЧИН СМЕРТИ, СТРУКТУРЫ ВТОРИЧНОЙ И СОПУТСТВУЮЩЕЙ ПАТОЛОГИИ ВИЧ-ИНФИЦИРОВАННЫХ ПАЦИЕНТОВ ГОМЕЛЬСКОЙ ОБЛАСТИ

Abstract

Background. The analysis of the spectrum of causes of death associated with HIV infection presents some difficulties, since a significant number of deaths of HIV-infected patients are not directly related to the manifestation of immunodeficiency. The goal is to determine the spectrum of secondary diseases, the immediate and main causes of death, as well as target organs for opportunistic infections and diseases of HIV-infected patients in Gomel region. Material and methods. The case histories, data of of infectious diseases and the protocols of pathological autopsies of HIV-infected patients in the Svetlogorsk district of Gomel region for 2012-2018 were studied. Results. Among HIV-infected deceased patients, men predominate (more than 60%), aged 35 to 44 years (about 50%). The number of deceased patients with the experience of infection from 1 to 12 years is decreasing and increasing from 13 to 21 years (28.4%). Life expectancy after HIV infection is 10.5 ± 4.9 years. Among HIV-infected deceased patients who had indicators of immune status, the content of CD4 + lymphocytes were less than 200 cells in 63.8% of patients, in 23.3% the number of CD4 + cells at the time of death was less than 50. Viral load in 22.4% of deaths at the time of death exceeded 500,000 copies/μl, the majority (89.2%) of the dead had the 4th clinical stage of HIV infection. Conclusions. In 74.6% of patients, HIV infection was the main disease and the main cause of death. Among the spectrum of secondary diseases that caused death pneumocystis pneumonia, progressive multifocal leukoencephalopathy, cryptococcal infection, toxoplasmosis of the brain, tuberculosis, lymphomas, CMV-infection, generalized candidiasis, atypical mycobacteriosis, pulmonary aspergillosis and others were identified. In 25.4% of cases, HIV infection was regarded as concomitant rather than the main pathology, among which liver cirrhosis and other pathologies predominated: acute cerebrovascular accident, coronary heart disease, chronic rheumatic heart disease, dilated cardiomyopathy, chronic alcoholic disease and others. The increase in the number of autopsies and constant monitoring of the causes of death of HIV-infected deaths and associated opportunistic infections and diseases will improve the quality and speed up the time-to-life diagnosis of various pathologies in HIV-infected patients.