The Features of the Course and Outcomes of HIV Infection Diagnosed at the Stage of Pronounced Immunosuppression

Abstract

Objective: to present the features of the course and outcomes of HIV infection diagnosed at the stage of pronounced immunosuppression.Material and methods. Based on the primary CD4 + T-lymphocytes count, 492 patients living with HIV were divided into 2 groups: group 1 - 220 patients (CD4 + TL less than or equal to 350 cells/μl), group 2 - 272 patients (CD4 + TL more than 350 cells/µl). The statistical analysis was performed using the package «Statisticа» v.10.Results. Among the patients of the first group there were more men than in the second group: 136 (61.8 %) and 125 (46 %), p < 0.001, respectively; more patients in HIV clinical stages 3 and 4 - 52.7 % and 27.6 %, p < 0.05; more ART patients: 208 (94.5 %) and 148 (54.4 %) p < 0.001, respectively. The levels of T-helpers and IRI (immunoregulatory index) in the patients of group 2 in the follow-up dynamics remained significantly higher compared with those of the patients of group 1. The incidence of tuberculosis was higher in group 1: 33 (15 %) and 15 (5.5 %), respectively, p < 0.05. In the first group, 23 (10.5 %) patients died, in the second - 9 (3.3 %), p < 0.003.Conclusion. HIV-infection at the stage of pronounced immunosuppression was diagnosed in 220 patients - 44.7 % (95 % CI: 40.4-49.1) of the cases. Severe immunosuppression in the primarily diagnosed patients was associated with the presence of HIV clinical stages 3 and 4 (OR - 2.9; 95 % CI: 2.0-4.3), higher incidence rates of tuberculosis (OR - 3.02; 95 % CI: 1.6-5.7) and fatal outcomes (OR - 3.4; 95 % CI: 1.5-7.5), a slower increase in T-helpers and IRI counts.