Method for predicting the development of tuberculosis in persons infected with HIV and held in penitentiary institutions

Abstract

Aim. To create a new prognostic index that allows screening and predicting the development of tuberculosis in persons infected with human immunodeficiency virus (HIV), from among the suspects, accused, convicts, and assessment of how an additional diagnostic criterion can become a justification for additional preventive and anti-epidemic measures. Methods. A mathematical model was developed by using expert opinions and applying the logical-mathematical approach of hierarchical analysis. It includes characteristics and criteria described in the modern scientific literature that does not exclude the presence of active tuberculosis or cause its unfavorable course in HIV-infected patients. The research was carried out in two stages. At the first stage, the weighting coefficients of the predictors used were calculated, and a prognostic index was created. At the second stage, the technique was applied in practice. As a result of the study in the observation group, which consisted of 157 clinical cases, the probability of tuberculosis was calculated by using the statistical grouping method. Results. A model for calculating the prognostic index of the development of tuberculosis in patients with HIV infection has been developed. Based on the example of patients held in prisons, a graphical method is proposed for assessing the possibility of development/absence of tuberculosis in HIV-infected individuals, depending on the value of the prognostic index. In the practical application of the developed prognostic index, tuberculosis was diagnosed in 37 patients, and plans of preventive measures were developed in 120 patients. Conclusion. The developed method of screening and predicting the development of tuberculosis in patients with HIV infection makes it possible to improve the timeliness of diagnosis of tuberculosis in the early stages and to determine the need for additional preventive or anti-epidemic measures during the work to counter the spread of this disease in the institutions of the Federal Penitentiary Service.