FEATURES OF CONCOMITANT HIV/TUBERCULOSIS DISEASES WITH FATAL OUTCOMES

Abstract

The issues of concomitant pathology of HIV infection and tuberculosis are becoming increasingly relevant in the period of improving the epidemiological situation of tuberculosis. HIV-associated tuberculosis is given more attention due to the peculiarities of the processes characterized by generalization, progression and high lethal outcomes. Objective. The purpose of this work is to study the characteristics of tuberculosis in patients with HIV infection in a region with a high prevalence of HIV infection with fatal outcomes. Materials and methods . For a comparative analysis, depending on the outcome of the disease, 2 groups were formed: 1 st group — 70 patients with tuberculosis and HIV infection (tuberculosis/HIV) who died within a month after admission to the tuberculosis hospital (main group), 2 nd group — 70 tuberculosis/HIV patients were discharged from the hospital with improvement (comparison group). All patients received treatment in accordance with clinical guidelines. In statistical calculations, the Pearson c 2 -criterion or the c 2 -criterion with the Yeats correction with the number of degrees of freedom f=1 (f=(r–1)×(c–1)) was used. The level of significance was taken as a value of 0,05 or less. Results . In the first group, tuberculosis was more often detected upon admission to non-main hospitals ( c 2 =5,28; р=0,0216), diagnosed with pneumonia ( c 2 =9,46 р=0,0021) in the absence of fluorography in the current year. Mortality was more common in people under the age of 30 years who had no family ( c 2 =18,72; p=0,00001) who were in prison ( c 2 =7,96; p=0,0048) and led an antisocial lifestyle. An analysis of the manifestations of tuberculosis revealed no differences that determine the lethal outcome. The difficulty of diagnosing tuberculosis occurred when the CD4+ level was less than 300 cells. Comorbidity of tuberculosis and HIV infection is characterized by a commonality of many clinical manifestations regardless of the outcome. The presence of burdened social status increases the likelihood of dying with concomitant HIV/TB diseases.