THE VALUE OF SERUM SEROMUCOID IN THE DIFFERENTIAL DIAGNOSIS OF BACTERIAL PNEUMONIA AND TUBERCULOSIS IN HIV-POSITIVE PATIENTS

Abstract

The aim: To optimize the differential diagnosis of bacterial pneumonia and tuberculosis in HIV-positive patients based on the value of serum seromucoid. Materials and methods: The study included 77 HIV-positive patients with lung pathology. The 1st group consisted of 44 HIV-infected patients with BP; the 2nd group – of 33 patients with HIV/TB co-infection. Level of SSM, CD4+ T-lymphocytes, HIV-1 RNA viral load was determined. Сlinical, laboratory, microscopic, radiological, microbiological, and statistical methods were used in the research. Results: In patients with HIV/TB co-infection CD4+ T-lymphocyte level was lower, and viral load was higher than in HIV-infected patients with BP. The level of SSM was statistically significantly elevated in patients of both groups compared with the control (p<0,001), but in patients with HIV/TB co-infection the values were statistically significantly higher (p<0,001). In patients with BP, the content of SSM≤15,95 TU occurred statistically significantly more often than in patients with TB (χ2= 65,5; p <0,001). No statistically significant relationship between SSM content and CD4+ T-lymphocyte levels was found. Conclusions: The content of SSM in patients with HIV/TB co-infection is statistically significantly higher than in the group of HIV-infected patients with BP. Determination of SSM level can be used as a rapid method of differential diagnosis of BP and TB in HIV-positive patients that will allow to optimize the diagnostic algorithm at the early stage of hospitalization and to receive the necessary timely treatment for HIV-infected patients.