Clinical characteristic, diagnosis and effectiveness of treatment of tuberculosis in HIV-infected patients in the Saratov region

Abstract

Aim: evaluate the clinical manifestations, efficacy of microbiological
diagnosis and results of treatment of patients with tuberculosis (TB) in combination with HIV (TB/HIV), residing in the territory of the Saratov region.

Materials and methods: analyzed the medical records (hospital records, medical history, personal record cards TB/HIV), 130 patients coinfected with TB/HIV who were on treatment in TB facilities of Saratov region in 2014.

Results: it was found that the combination of TB and HIV infection was more common in men (71,5%) aged 30–39 years, mostly (75,4%) residents of large cities. TB in 64,6% of cases develop on the background of existing HIV infection with disease duration from 1 to 18 years. The dominant forms of TB were infiltrative – 50,8% and disseminated – 25,4% with high levels of multidrug resistance (MDR) – 25% and polyresistance – 17,3%. Efficiency a course of treatment of ТВ which was completed in 2014 year amounted to 41,5% and was higher in the group of patients in which treatment with anti-tuberculosis therapy is used antiretroviral therapy (ARVT) – 49,3% versus 30,9% without ARVT, p = 0,0416. It was found increase of CD4 cell counts after treatment in patients TB/HIV, which, together with anti-tuberculosis therapy received ARVT 301 ± 45 cells/microliter vs. 202,3 ± 32 cells/microliter in patients without ARVT, p=0,0416.

Conclusion: determined that TB in patients with HIV infection characterized by severe course of the process with low efficiency of treatment and high MDR, which requires the strengthening of measures to control the spread of TB in these patients.