ETIOLOGICAL VERIFICATION OF TUBERCULOSIS IN CASE OF SYSTEM INFLAMMATORY SYNDROME IN HIV PATIENTS

Abstract

The objective: to study the efficacy of etiological verification of tuberculosis in case of systemic inflammation syndrome in HIV patients. Subjects and methods. 116 HIV patients were examined; all of them were admitted to hospital due to systemic inflammatory syndrome (SIS). In order to diagnose tuberculosis, clinical, bacteriological, and instrumental examinations were performed. Specimens of venous blood were used for the detection of tuberculous mycobacteria by RT-PCR and culture. Results. More than half (64.6%) of cases of systemic inflammatory syndrome in the examined HIV patients was due to tuberculosis onset. The degree of immunity suppression (considering CD4 count) in SIS patients with tuberculosis onset and various HIV-associated pathologies was not statistically significantly different. The frequency of MTB DNA detection by RT-PCR in venous blood in case of verified tuberculous sepsis (non-academic term) in TB/HIV patients made 29.3%, and taking into account positive results of blood culture in 5 patients with no MTB DNA found in the blood, the efficiency of diagnosis of tuberculosis in blood specimens reached 33.3%, while efficiency of blood cultures for MTB made 36.0%, with 100% specificity. Repeated PCR tests and blood cultures performed in some patients allowed increasing the total efficiency of blood tests.