COMORBIDITY OF PULMONARY TUBERCULOSIS AND BACTERIAL PNEUMONIA IN PATIENTS WITH LATE STAGES OF HIV-INFECTION WITH IMMUNODEFICIENCY

Abstract

AbstractPurposeTo study specifics of diagnostics and clinics of comorbidity of pulmonary tuberculosis and bacterial pneumonia in patients with HIV-infection with immunodeficiency.Materials and methodsNinety-three first-time diagnosed patients with pulmonary tuberculosis and 4B stage of HIV-infection in the advanced phase in the absence of antiretroviral therapy were examined. The patients were divided into 3 groups. The 1stgroup included 31 patient with pulmonary tuberculosis and pneumonia associated withStreptococcus pneumoniae, the 2ndgroup included 31 patient with pulmonary tuberculosis and pneumonia associated withStaphylococcus aureus. The 3rdgroup included 31 patient without bacterial pneumonia selected by a copy-pair principle. Statistical treatment of the data was performed using Microsoft Office Excel 2019 with calculation of the mean parameter in the group and the standard error of the mean confidence interval (CI).ResultsComorbidity of pulmonary tuberculosis and pneumonia associated withS. pneumoniaeorS. aureusin patients with 4B stage of HIV-infection with immunodeficiency in the advance phase with absence of antiretroviral treatment is characterized with generalization of tuberculosis and development of opportunistic infections of the lungs with severe clinical picture, high level of drug resistance ofM. tuberculosisand the agents of bacterial pneumonia. At computed tomography of the chest a focal dissemination is revealed in the lungs as well as an intrathoracic lymphadenopathy and changes of the lung pattern, which almost does not differ in patients with bacterial pneumonia.ConclusionClinical signs and X-ray changes in combination of pulmonary tuberculosis and pneumonia associated withS. pneumoniaeorS. aureusand pulmonary tuberculosis with bacterial pneumonia at the late stages of HIV-infection with immunodeficiency have the same type of character that can be diagnosed only with special microbiological viral and molecular genetic studies of abnormal material from the respiratory system and other organs with obligatory determination of drug resistance to the antituberculosis drug products and the antibacterial agents of wide spectrum.