Morphological features of secondary lung tuberculosis in HIV-patients

Abstract

In modern conditions, socially dangerous diseases (tuberculosis, HIV infection) are characterized not only by a high level of epidemiological indicators, but also by profound changes in the pathogens themselves (multiple drug resistance, etc.), changes in the course of diseases, its’ complications, causes of death, clinical and morphological manifestations, the appearance of co-infections, which is regarded as a negative phase of pathomorphosis or as reversion. At the same time, the pathomorphosis of diseases significantly complicates their diagnosis. There are objective reasons that do not allow to verify certain nosological units. Under conditions of nosomorphosis due to changes in the biological properties of the pathogen and reactive properties of the organism, in clinical practice and in the study of sectional, surgical and biopsy materials often have difficulties in diagnosis of various forms of tuberculosis and HIV, patho-, morpho- and thanatogenesis. Untimely diagnosis often leads to disability and mortality of patients. Therefore, in clinical practice, undiagnosed forms of socially dangerous diseases are more common. In 2018 251,000 people who had both TB and HIV are estimated to have died1. This is in addition to the 1.2 million people who died from TB alone. A total of 477,461 TB cases among HIV positive people were reported in 2018 (56% of the estimated incidence of 862,000 cases)2. Of these 86% were on antiretroviral therapy. In comparison, in Ukraine in 2019 5943 HIV deaths were reported, 1448 among them had TB and HIV coinfection (24.36%) and 811 of them were on antiretroviral therapy (56%). Due to all these statistics we can make a conclusion that TB in HIV patients is one the main causes of death in HIV-patients. Furthermore, due to the statistics even antiretroviral therapy does not have great affection on the TB and HIV coinfection course. TB/HIV coinfection is a global substantial problem and it means that all international guidelines have to be better implemented.