Manifestations Of HIV Infection Research Articles

A Rare but Sinister Case of Hodgkin Lymphoma Transforming into Large B-cell Lymphoma in HIV Infected Patient

A dual diagnosis of cancer and HIV places a greater psychosocial burden on the patient. From a medical perspective, it complicates treatment for both diseases. Potential drug interactions, compounded side effects, and chemotherapy’s tendency to negatively impact CD4 count or HIV viral load, can all complicate treatment. It is imperative to advocate a keen and subtle vigilance while managing such patients to enhance the overall care for the patients. Here, we report such a case in a 36-year-old man who presented with HL as first manifestation of HIV infection that later transformed into DLBCL despite successful virologic suppression with ART

Penile Kaposi Sarcoma: The First Manifestation of HIV Infection.

Penile Kaposi Sarcoma: The First Manifestation of HIV Infection.

Peningkatan Kapasitas dan Deteksi Dini HIV/AIDS Pada Remaja di Kota Baubau

HIV/AIDS is one of the deadliest diseases for which a cure has not been found, so innovation is needed to cure people with HIV/AIDS. AIDS is a manifestation of HIV infection that significantly suppresses a person's immune function. The aim is to increase the knowledge of adolescents and to detect the HIV status of adolescents in Baubau city. The method used is by way of counseling and examination. The results obtained are that there is an increase in adolescent knowledge and the results of the HIV-AIDS rapid test show that 98% of adolescents are aware and willing to carry out an early examination to determine their HIV status as an effort to prevent HIV transmission.

Psychiatric manifestations in HIV infection

IntroductionThe HIV is a retrovirus, which is immunosuppressive, predisposing the individual to opportunistic infections and certain neoplasm. In addition to impairment in immune functions, evidence has suggested that HIV is neurotropic. It should therefore be anticipated that neuropsychiatric complication might be common in HIV positive individuals during all phases of HIV related illness. The neuropsychiatric aspect of the AIDS remains a challenge for psychiatrists involved in patients care.The relationship between HIV and psychiatric symptoms and conditions is complex and the direction of effects between severe mental illness and HIV infection is unclear. In general, people with severe mental illness are at increased risk of contracting and transmitting HIV, and the prevalence of HIV infection among them is higher than in the general population.ObjectivesTo determine how frequently psychiatric symptoms in an HIV positive adult population occur, as well as to determine social, demographic and clinical factors that are associated with the presence of these symptoms.MethodsLiterature review on PubmedResultsDepression has a high prevalence in HIV-positive individuals, ranging between 5.8 and 36.0%. Typical features of depression are similar to those in HIVnegative people, although fatigue, loss of appetite and weight, impaired concentration, hopelessness and guilt are more common.Depressed HIV-positive individuals are at high suicide risk.Apathy has also been more commonly reported among HIV patients than in the general population.The prevalence of anxiety among HIV-positive individuals ranges from 4.3 to 44.4%ConclusionsThe rate of psychiatric symptoms in HIV positive patients in this population is high. Most of them go unnoticed and therefore untreated.DisclosureNo significant relationships.

HIV-ASSOCIATED ARTHRITIS. Review and clinical cases

Relevance. HIV infection is characterized by a wide spectrum of clinical manifestations, including musculoskeletal symptoms, which can occur at any stage of the disease.
 Objective: to analyze own clinical cases with rheumatologic manifestations of HIV infection in context of literature data on the spectrum of musculoskeletal manifestations of HIV infection, approaches to diagnosis and treatment.
 Methods. Presentation of own clinical cases and review of scientific publications in the international electronic scientometric database PubMed using keywords «HIV infection», «arthritis», «musculoskeletal manifestations» over the period 2000-2021 years.
 Results. The prevalence of musculoskeletal symptoms in HIV-infected individuals ranges from 10 to 45%. Articular manifestations of HIV infection can be divided into 3 main groups: 1) related to HIV (arthralgias, painful articular syndrome, HIV-associated arthritis, septic arthritis); 2) inflammatory arthritis (rheumatoid arthritis, reactive arthritis, psoriatic arthritis, undifferentiated spondyloarthritis); 3) associated with antiretroviral therapy (aseptic necrosis, osteoporosis, osteomalacia, immune reconstitution inflammatory syndrome, gout). For treatment of articular manifestations analgesics, nonsteroidal anti-inflammatory drugs (drug of choice - indomethacin), intraarticular or oral glucocorticoids, disease-modifying antirheumatic drugs (drug of choice - hydroxychloroquine) may be used. Conditions for initiation of therapy with disease-modifying antirheumatic drugs: a controlled steady course of HIV with antiretroviral therapy performed, the number of CD4+ cells >200/ml, undetectable viral load. Our clinical cases confirm that indications for HIV testing in rheumatologic patients are reactive arthritis of unknown etiology, atypical lupus, persistent leukopenia, unreasonable weight loss, lack of an adequate response to traditional therapy of rheumatological diseases.
 Conclusions. Articular syndrome in HIV-infected individuals may be a separate manifestation of HIV infection and result of antiretroviral therapy. Treatment of articular manifestations in HIV-infected individuals primarily involves the treatment of HIV infection, and it depends on its clinical stage, use of antiretroviral therapy, the severity of articular syndrome and involvement of other organs. Our clinical observations demonstrate the possibility of articular manifestations at various stages of HIV infection: before diagnosis, during prolonged stable antiretroviral therapy, as well as after a change in antiretroviral therapy.

Stage C neuro-HIV revealed by head tremor: a case study with review of the literature

The neurological manifestations of HIV infection are very numerous and varied. In 2018, in Morocco, 30% of seropositive subjects are unaware of their infection. Our patient was one of them. Observation: Authors report the case of a 28-year-old woman, widowed at the age of 20 after a traffic accident. In 2009, she moved to Senegal with the onset of chronic consumption of tobacco and alcohol and unprotected sexual relations with multiple partners. The patient was admitted to our training for an insidious symptomatology going back a year, marked by tremor of the head, improved by the alcohol intake, in a context of weight loss not quantified. The examination objectified a statokinetic cerebellar syndrome. Brain magnetic resonance imaging (MRI) did not show any atrophy or cerebellar damage. The main diagnoses discussed were: sequelae of viral cerebellitis, neurological complications of alcohol intoxication and essential tremor. The complete blood count demonstrated lymphopenia at 660 µL. The HIV and CMV serologies came back positive. Universal meningeal PCR returned VZV. The diagnosis of cerebellar VZV on AIDS was retained. The patient was initially put on Ganciclovir with marked regression of the tremors then on triple therapy after announcement of the diagnosis. Conclusion: The VZV is the 2nd cause of viral cerebrellitis after the West Nile virus. It can be seen in both the immunocompetent and the immunocompromised. The absence of a concomitant rash is not an exclusion criterion. However, its presence makes diagnostic suspicion easier.
 Keywords: head tremor, cerebellitis, HIV, VZV, alcohol, essential tremor.

Effect of reporting a diagnosis on the behavior of HIV-infected people

Relevance. According to US scientists, the percentage of people who do not know about their positive status is 20% of all people living with HIV. Moreover, this group provides 49% of new infections. Therefore, it can be assumed that information about HIV status has a significant epidemiological effect. Aim. To assess the change in risk behavior of HIV-infected persons after informing about the diagnosis and the frequency of occurrence of nonspecific symptoms of HIV infection. Materials and methods. For information on changing the behavior profile was developed, consisting of three sections. The first and third sections are aimed at elucidating the characteristics of sexual and drug behavior from the moment of probable infection to the moment of diagnosis, in comparison with the time period from the moment of reporting the diagnosis to the present. The second section of questions is aimed at determining the frequency of occurrence of nonspecific symptoms of early HIV infection. In the survey agreed to participate in 79 HIV-infected patients. The reliability of the results obtained was determined using the Wilcoxon Sign Test. Results. The message of the diagnosis of HIV infection contributed to the desire to abandon the systematic use of intravenous drugs. The proportion of people who denied drug use increased from 13 to 65% (p < 0.05). The number of people infected intensively (30 and more doses / month) using drugs has more than halved – from 38 to 17% (p < 0.05). The number of people denying drug use in groups increased from 10 to 45% (p < 0.05). From 55 to 12% (p < 0.05), the proportion of people who pass their syringe (needle) to another person to inject drugs has decreased. The number of persons who noted the presence of more than 5 partners per year after diagnosis decreased three times (p < 0.05). Only 23% of the respondents did not present any complaints in the period preceding the detection of HIV infection. Symptoms of acute respiratory disease marked 48%, 37% had fever, and other non-specific clinical manifestations of HIV infection. Conclusion. Communicating a positive HIV status to a patient reduces the likelihood of HIV transmission by drugs by 3–4 times and sexually by 2–3 times by changing risky behavior. Nonspecific symptoms of an acute viral disease before the detection of HIV infection were recorded in 48% of cases.

Inflammatory tumor of the base of the tongue as a clinical presentation of HIV infection

<b>Introduction:</b> AIDS is a fatal disease that impairs the immunity, increasing the risk of developing opportunistic infections. <br/><br/><b>Case report:</b> We present a case of a 47-year-old patient from the ER, with bleeding from a tongue tumor. The patient reported that he had lost 25 kg in about six months and complained of swallowing disorders. HIV infection was confirmed in the patient during the diagnosis. The inflammatory tumor of the tongue was the only manifestation of HIV infection.

Clinical and immunological characteristics of bacterial pneumonia associated with HIV infection coupled to drug addiction

Bacterial pneumonia holds the second place after respiratory tuberculosis in patients with HIV infection. In recent years, sexual transmission of HIV was replaced by injection drug route. It seems of high relevance to advance medical aid to patients with HIV infection and bacterial pneumonia depending on psychoactive substance use.Aim of study — assessment of clinical and immunological manifestations of bacterial pneumonia coupled to HIV infection with respect to verified injection drug use.Materials and methods. Clinical and immunological data collected from 224 patients with HIV infection and pneumonia were retrospectively analyzed: group 1 group — 70 patients with HIV infection, IDU, verified bacterial pneumonia; group 2 — 16 injecting drug users (IDU) with HIV infection and pneumonia of unverified etiology; group 3 — 65 patients with HIV and bacterial pneumonia of verified etiology without injection drug use, group 4 — 73 patients with HIV infection and bacterial pneumonia of unverified etiology, without injection drug use. The data obtained were analyzed by using software Statistica 13.3. Methods of descriptive statistics with calculation of nonparametric criterion — the Kruskall—Wallis test (H-criterion) and χ2 test — were used.Results. Immunological manifestations of HIV infection and bacterial pneumonia were characterized by decreased count of CD4+ cells paralleled with increased count of CD3+ and CD8+ cells at higher magnitude without injection drug use being also featured with peak viral load upon developing pneumonia. Bacterial pneumonia coupled to HIV infection showed clinical manifestations similar both in injecting drug users and non-users, proceeding in 10% cases during normothermia. Injection drug user patients often demonstrated clinical picture of pneumonia resembling those found in sepsis such as pain in the body, muscles, bone aches untypical to HIV-sexually infected subjects. In addition, systolic murmur on a heart top was more often auscultated in this patient group.Conclusion. Subjects self-considered healthy being at risk of sexually transmitted infections should examined for HIV. All subjects manifested with symptoms of the lower airway tract infections in admission department should not be rejected to be hospitalized and undergo chest X-ray examination.

Dynamics of Epidemiological Manifestations of HIV Infection in the Gender Aspect (on the Example of the Republic of Tatarstan)

Relevance. The development of the HIV epidemic in different parts of the word is accompanied by the dynamics of its manifestations, including a change in the role in epidemics of various routes of transmission, “risky groups” and shifts in the gender structure of morbidity. The study of the epidemic process in dynamics, including the gender indicators of the epidemic, is important for forecasting the epidemic and modernizing prevention strategies. The aim of the study is to assess the gender characteristics of the manifestations of the epidemic process of HIV infection in the Republic of Tatarstan. Materials and methods. A retrospective analysis of the incidence of HIV-infection among women and men in the Republic of Tatarstan (Russia) for the period of 1996–2018 was carried out. We used information from database of AIDS-centre of Tatarstan Republic. Incidence of HIV in association with age, ways of transmission, social status was calculated for men and women separately. We analyzed the role of main transmission routes in different age groups over the entire period of the epidemic (1987–2018). The data is processed in Microsoft Office Excel 2010. Results. Incidence rate of HIV per year in men is higher then in women from 1999 (p < 0,05). In the structure of the adult population's incidence of HIV infection, the proportion of women increased by 2.4 times: from 14.8 ± 0.7% in 2001 to 35.6 ± 1.3% in 2018 (p < 0.001). During the entire follow - up period of 1996-2018, the most common route of getting infection for men was intravenous (68%); most of women (73,3%) got HIV via sexual rout including women, living in areas with the highest prevalence of drug addiction. The proportion of sexual route of HIV-transmission increased from 5.6 ± 0.5% in 2001 to 52.3 ± 1.7% in 2018 for men, and from 23.7 ± 2.2% in 2001 to 84.6 ± 1.7% in 2018 for women (p < 0.001). Dynamic of HIV-epidemic is presented by involvement of older age groups. With age, the proportion of people who were infected via sexual rout increases in both women and men groups. Conclusion. The dynamics of the epidemiological manifestations of HIV infection in the Republic of Tatarstan for the period 1996–2018 has many similarities among women and men: they have unidirectional changes, and the incidence rates decreases for people under 30 years. The incidence rates for men are higher than those for women, however, the development of the epidemic is accompanied by an increase in the proportion of women, for whom, unlike men, regardless of the age and prevalence of drug addiction in the territory the live, the sexual route of infection is predominant.

The Efficiency of the Fight Against HIV, in Constanta, from the Perspective of Neurological Complications

Abstract In order to control and end the AIDS epidemic, we all need to hit the 0-0-0 target. That means 0 HIV infections, 0 mortality caused by AIDS and 0 discrimination. We performed a retrospective observational analytical study on 166 HIV positive patients with a neurological complication, diagnosed between June 2012 and June 2020, in Clinical Infectious Diseases Hospital of Constanta. We collected data from the observational charts that revealed if the patient was known with HIV infection at the time of the neurological complication diagnosis, information about the treatment (how many treatment regimens, classes of antiretroviral drugs, CNS Penetration-Effectiveness Rank), treatment compliance. The patients were divided into two groups: first group “opportunistic infections (OI)” and second group “other neurological conditions (ONC)”. 16 patients (9,6%) have the neurological condition as first manifestation of HIV infection. Opportunistic infections, correlated with a poor immunological status continue to have a high percentage (46,98%) of neurological complications, being associated with a poor treatment compliance (p&lt;0,001). Integrase inhibitors were associated, in this study, more with opportunistic infections and less with other neurological conditions (OR=2,885; 95% IC), this finding needs further research. Long term survivors have problems with treatment compliance manifesting treatment fatigue, even if they have treatment regimens with good CNS penetrability. Poor compliance is associated with high risk of opportunistic infections and opportunistic infections have a higher mortality than other neurological complications. Our task for the future is to find ways to improve treatment adherence in order for HIV patients to have a better and longer life.

The evaluation of level of awareness of student youth of issues of HIV-infection

The article presents the results of study targeted to assessing the level of awareness of students about HIV-infection. On the basis of analysis of publications data, it was established that students of the Russian universities are generally informed about ways of transmission HIV-infection and means and measures of its prevention. It was demonstrated that Russian students are not sufficiently aware of the clinical manifestations of HIV-infection, they do not fully understand the danger of HIV infection as a fatal disease, and often experience phobias against persons living with HIV-infection. The article presented the results of empirical survey of students of the Cherepovets State University (n = 103). The methods of research included statistical analysis, questionnaire, Spirman's rank correlation coefficient. It was established that majority of respondents underestimate the risk of HIV-infection and lack reliable information about prevalence of HIV-infection in the territory of residence. The correlation analysis demonstrated that information about HIV-infection is more significant for students who believe that HIV-infection can concern them. In addition, such students tend to be more tolerant to virus carriers. Along informing students about HIV-infection, it is necessary to train them for responsible behavior in different life situations.

Complications of HIV infection

HIV-infected patients often develop various complications and comorbidities including opportunistic diseases that worsen patient’s general state and decrease antiretroviral treatment effectiveness. On the other hand, the diagnosis of HIV infection often begins with the identification of complications, and only then, the main disease is diagnosed. Early detection of these complications and comorbidities is essential for timely and effective treatment of patients with HIV infection. In addition, an important issue is the differential diagnosis of complications caused directly by HIV, opportunistic infections and antiretroviral therapy, since each of these groups of complications needs its own approach to treatment. The literature review of PubMed resource performed in this work allowed us to present the main complications of HIV infection and to separate them by the location of the lesion and the cause of occurrence, which facilitates the perception of information. Neurological, cardiopulmonary and gastrointestinal complications are described in detail, since the violation of these systems occurs in HIV-infected patients most often. The main causing factors, the features of clinical manifestations, detection and diagnosis by visualization, serological, microbiological, histological and other methods are described in the study. The main directions of HIV infection complications treatment, the features of the patient’s condition in which it is advisable to use certain methods of treatment, a plan for further patients monitoring are also described. Other rare lesions, such as urogenital, musculoskeletal, metabolic and endocrine complications, are also described. It has been found that the manifestations of HIV infection are variable and depend on the stage of HIV infection, the level of CD4+ cells, viral load, the presence of opportunistic diseases and the antiretroviral therapy regimen used. The features of the etiology, pathogenesis, clinical manifestations and treatment of HIV infection complications described in the article can help doctors of all specialties in early detection, treatment and prevention.

Peripheral haematological manifestations in HIV infection and its relation to CD4 count

Background: HIV infection is associated with a wide range of haematological abnormalities, which are amongst its most common complications. This study aims at discerning the peripheral haematological abnormalities associated with HIV infection and to correlate them with CD4 cell count.Methods: An observational cross-sectional study was conducted from March 2017 till August 2018. 109 patients in 15 years or more age group who were HIV positive by the NACO guidelines were included. Complete hemogram, serum iron studies, serum folate and vitamin B12 levels, and flowcytometric CD4 cell count analysis were done for all the patients. Various haematological parameters were compared between the patients with CD4 cell counts &lt;200/µl (n=52) to those with counts &gt;200/µl (n=57). By using student t-test, the p-value was calculated for various parameters.Results: Anaemia (58.7%), leucopenia (27.5%) and thrombocytopenia (17.4%) were seen with anaemia being the most common abnormality. Normocytic normochromic anaemia (65.6%) was the predominant type of anaemia. Overall analysis showed a statistically significant difference between two groups in haemoglobin concentration, RBC indices, serum ferritin values and absolute lymphocyte count; with p-value &lt;0.05.Conclusions: The diagnosis and treatment of haematological disorders are essential in medical care of the HIV-infected patients. Thus, in resource limited setups, where CD4 count analysis is not possible, haematological abnormalities can be used as tools for monitoring HIV positive individuals and can aid in the treatment of the patients.

Dermatological aspects of HIV infection: personal clinical observation

Skin and mucous membrane lesions are significant clinical manifestations of HIV infection. Dermatoses associated with HIV infection are characterized by persistent, increasing severity. Atypical symptoms may occur. These dermatoses are resistant to therapy. They are often associated with lymphadenopathy. These criteria are sufficient grounds for supposing the presence of HIV infection, especially when taking into account visceral and systemic abnormalities, as well as the general status of the patient.Up to 92 % of HIV-infected people suffer from various dermatoses. In 72 % of patients, two or more skin diseases occur simultaneously. Skin and mucous membrane lesions in patients with HIV are often one of the first manifestations of HIV infection. Hence, the role of the dermatovenerologist consists in the timely detection of HIV infection. The spectrum of skin lesions in HIV infection is extremely wide. Conventionally, there are three main groups of dermatoses: infectious, non­infectious and neoplastic.Clinical examples were given of skin pathologies manifestation in HIV­infected patients as the first HIV infection display in the patients.Examination on HIV infection was conducted in the clinicodiagnostic laboratory of regional communal establishment «Kryvyi Rih Dermatovenerologic dispensary» with making rapid immunochromatographic tests «Wantai Bio­Pharm» and carrying out immunoassay studies using immunoassay systems for the determination of antibodies to the human immunodeficiency virus of the first and second types «Recombinant-HIV 1,2-MBA MedBioAlliance, Ukraine».HIV-­status in the inspected patients was confirmed by the reference­laboratory of Kryvyi Rih AIDS Prevention and Cont­rol Centre. Clinical cases of HIV infection in patients with various dermatoses were considered, in particular, in a patient with seborrheic dermatitis and disseminated streptoderma, in a patient with pustular psoriasis, in a patient with rosacea. Cases of HIV associated with toxicoderma and urticaria were described.The presence of various opportunistic infections in HIV-infected patients, as well as various dermatological manifestations, requires greater vigilance of dermatologists and family doctors as first-time doctors in order to improve timely diagnosis and treatment effectiveness.

Ocular manifestations of HIV infections in southern India in the era of HAART

Ocular manifestations of HIV infections in southern India in the era of HAART

Cystic Lesions of the Parotid Salivary Gland: a Clinical Dilemma

Cystic lesions within the parotid gland are uncommon and frequently misdiagnosed as parotid tumors clinically. We report a 43-year-old female with a case history of painless, soft, fluctuant swelling of left parotid. The lesion was found out to be cystic through the preoperative examinations and investigations. The cyst was completely excised along with the superficial lobe of the parotid taking care not to injure the facial nerve. Postoperative recovery was uneventful with no defect in facial nerve functions. The histopathological picture was suggestive of lymphoepithelial cyst which is also known as “branchial cyst.” We report this case on account of its rarity and clinical take home messages learnt during management of this case, namely, mandatory HIV testing for cystic lesions of the parotid gland as cystic parotid swellings commonly present an early manifestation of HIV infection, and, secondly, aspirations of the cystic lesions are not advised as chances of recurrence are high as it did in our case.

Skin Manifestations of HIV Infection in Children in Pediatric Services of Conakry University Hospital (Guinea)

Introduction: Dermatological manifestations during HIV infection play a diagnostic and prognostic role. They are observed in 83% - 98% of patients at the late stage of AIDS and 58% - 75% at an early stage of AIDS. The objective of this study was to determine the prevalence of skin diseases in HIV in children, describes the demographic profile and identify key dermatoses. Material and methods: This was a prospective study of descriptive kind conducted from August 25, 2009 to February 25, 2010. It involved children infected with HIV followed in pediatric services at the University Hospital of Conakry. All children were examined by an experienced dermatologist. The diagnosis of dermatosis was made according to the clinical signs. The stages of HIV infection were determined according to the WHO classification. Each child received retroviral serology rapid tests according to national algorithm. Results: Among 119 HIV-positive children 65 showed mucocutaneous manifestations, there are 34 girls and 31 boys, all HIV-1 infected with 66.16% in stage III disease. The average age was 7 years, ranging from 11 months to 15 years. 66.15% of the children were from married mothers and more than half of the mothers were illiterate. They were all positive for HIV1. Oral candidiasis (38.46%), prurigo (29.23%) and molluscum contagiosum (7.69%) were the most common skin diseases; 52.31% had at least two associated dermatoses. The candidiasis-prurigo combination (26.47%) was the most common. Dermatosis was often associated with other conditions: malaria (30.76%), pulmonary tuberculosis (25.61%) and malnutrition (12.30%). Discussion: With 65 cases diagnosed in six months our study shows that skin diseases are common in HIV among children in Guinea. The prevalence and socio-demographic characteristics are close to those reported by sub saharian and North African authors. A special feature of the study is that most mothers are illiterate and are infected with HIV, which would have favored the contamination of these children. Conclusion: In Sub-Saharan Africa where the rate of pediatric HIV infection is increasing, it is important to identify the mucocutaneous manifestations for optimal care.

Opportunistic infections in HIV infected children and its correlation with CD4 count

Background: HIV infected children usually have higher viral load, weaker immune system, variable latency period, fewer opportunistic infections and fewer medicines approved for management. Knowledge of the clinical profile in HIV infected children will help in better understanding of the disease and management. The present study was aimed to study the clinical presentation, opportunistic infections, WHO clinical stage, nutritional status and its correlation with CD4 count.Methods: 50 children below 14 years of age and seropositive for HIV were included in this study and were categorized into WHO clinical stages. They were further classified based on CD4 count values in accordance with WHO classification of immunodeficiency.Results: In the study 30% of children were in the age group of 4 to 7 years. The mean age of presentation was 7.12 years. 56% of children presented with WHO clinical stage III and 30% with stage IV at first visit. Vertical transmission was the predominant mode of transmission. Anaemia (48%), fever (42%) and cough (34%) were common symptoms. Pulmonary tuberculosis (28%) was the most common opportunistic infection seen at mean CD4 count of 267±5.37.Conclusions: The manifestations of HIV infection in children mimic a number of other illnesses. Anaemia, fever and cough were the common presenting clinical features. Tuberculosis is the most common opportunistic infection in HIV infected children. As WHO clinical stage and grade of PEM increases CD4 count decreases. CD4 count is a reliable marker of disease progression in HIV infected children.

The simultaneous detection of tuberculosis and HIV-infection

The clinical and roentgenologic manifestations of tuberculosis in cases of its detection simultaneously with HIV-infection are considered. The physician is to be guided by different techniques of radiologic diagnostics because of low rate of bacteria isolation for timely detection of HIV-combined tuberculosis. In case of simultaneous detection of HIV-infection and activation of endogenous tuberculosis infection with development of tuberculosis in the same individual, the infection with HIV-infection occurs as a primary one. The specific inflammation develops against the background of immunodeficiency induced by HIV-infection. This occurrence can take place both at the stage of primary manifestations of HIV-infection (stage II) and late stage (stage of secondary diseases).