Etiological Diagnosis of Infectious Coxitis Depending on the Patient's HIV Status

Abstract

The objective: to develop the procedure for etiological diagnosis of infectious coxitis (IC) depending on the patient's HIV status.Subjects and Methods. The data of medical records of 97 patients with signs of IC were analyzed. Patients were divided into group depending on their HIV status.Results. The time required to diagnose IC was identified, and it made 7.35 ± 1.30 months for HIV-positive patients, and 6.25 ± 0.90 months for HIV negative patients (p > 0.05). The procedure was developed to be implemented when a patient complained of pain in the hip joint. Patients with HIV infection and suspected IC should undergo computed tomography (CT) of the hip joints, and HIV-negative patients should have CT done if the hip joint X-ray is not informative. The use of CT in the HIV+ Group reduced the diagnostic time from 9.4 ± 1.3 to 5.3 ± 1.3 months (p = 0.680), in the HIV- Group – from 8.7 ± 1.2 to 3.8 ± 0.6 months (p = 0.02). The reason why diagnosis took that long was the rare use of invasive methods at the outpatient stage. Thus, puncture of the hip joint was performed in the HIV+ Group in 2.7% of cases, in the HIV- Group – in 10%. Trepanobiopsy performed in a hospital made it possible to establish the etiology of IC in all patients. The diagnostic efficacy of microbiological tests in case of tuberculous coxitis made 48.64% in the HIV+ Group and 30.0% in the HIV- Group, in case of nonspecific coxitis it was 32.43% and 30.0%, respectively.