Characteristics of new cases of infiltrative pulmonary tuberculosis in patients having HIV infection with multidrug resistance of the pathogen according to multi-layer spiral computed tomography

Abstract

Background. Identification of the characteristics of the pulmonary tuberculosis process using multi-layer spiral computed tomography (MSCT) in patients with tuberculosis and HIV infection is important in the diagnosis of tuberculosis, determining the dissemination of the process and its dynamics during treatment. The aim. To determine the initial characteristics and dynamics of infiltrative tuberculosis according to MSCT in patients with and without HIV infection, with and without multidrug resistance (MDR) of Mycobacterium tuberculosis who were treated in a hospital. Materials and methods. 126 patients aged 19–59 years with tuberculosis, combined with HIV infection and without HIV infection were examined. For statistical processing, we used MS Excel (Microsoft Corp., USA) software package. Results. Patients with tuberculosis and HIV infection in comparison with patients with tuberculosis and without HIV had more expressed intoxication syndrome and respiratory impairement in the clinical picture (p < 0.00001). Patients with coinfection were more likely to suffer from alcohol (p < 0.05) and drug addiction (p < 0.001). According to MSCT, the pathological process in HIV-positive patients with pulmonary tuberculosis was more disseminated (p < 0.05), included severe intrathoracic lymphadenopathy (p < 0.0001), more common pleural lesions (p < 0.005), less common destructive changes (cavities) (p < 0.001) and outcomes in form of fibro-cavernous tuberculosis (p < 0.01). Process regression was slower in patients with tuberculosis and HIV (p < 0.005). According to MSCT, extensive lung damage, intrathoracic lymphadenopathy were more often found in patients with MDR in coinfection (p < 0.05). Cavities and fibro-cavernous tuberculosis outcomes were more common in patients with tuberculosis without HIV infection and with MDR (p < 0.05). Conclusion. MSCT provides detailed information about the pathological process in the lungs and its dynamics under the treatment of tuberculosis and HIV infection.