RESULTS OF LONG-TERM FOLLOW-UP OF PATIENTS WITH HIV/TUBERCULOSIS COINFECTION

DOI: https://doi.org/10.29296/25877305-2023-06-10
Issue: 
6
Year: 
2023

E. Vdoushkina, Candidate of Medical Sciences; Professor B. Borodulin, MD; Associate Professor E. Eremenko, Candidate of Medical Sciences
Samara State Medical University, Ministry of Health of Russia

The problem of combined HIV/tuberculosis infection is characterized by a broad social orientation, a serious risk factor for the development of the disease and a factor of death is the use of narcotic substances. The number of patients with HIV/tuberculosis co-infection in the Russian Federation remains high, the majority of cases of tuberculosis in patients with HIV infection are detected in the late stages of the disease, mainly when patients turn to the general treatment network. In recent years, the situation has been complicated by an increase in the proportion of cases of sexual transmission of HIV, the number of infected among young women is growing. The problem of drug resistance of Mycobacterium tuberculosis creates many difficulties in terms of diagnosis and treatment. The course of the tuberculosis process in HIV patients, due to pronounced immunosuppression, is often atypical, TB diagnosis is especially difficult at the stage of severe immunodeficiency, the tuberculosis process often proceeds in a generalized form. Treatment of comorbid patients is also a big problem due to the simultaneous administration of a large number of anti-tuberculosis drugs in addition to their lifelong HIV treatment, which leads to a decrease in adherence to treatment. The article presents data from an 11-year follow-up of a cohort of patients with HIV infection and tuberculosis. The clinical and anamnestic data, the experience of HIV infection, the timing and causes of deaths were evaluated. The patients were mainly young men (70%) with a high level of intravenous drug use (77.5%), high hepatitis C virus infection (55%), severe immunosuppression (60.1%), a significant proportion of MDR (43.8%), lack of adherence to antiretroviral therapy (58.8%). 51.25% of patients died during the follow-up period. Due to the high risks of death and other failures of tuberculosis treatment in patients with HIV/TB comorbidity, studies of the results of management of such patients in the long term remain a priority for all regions of the country. The problem of detecting tuberculosis in patients with HIV-infection remains urgent, which requires the interaction of both the phthisiological service and infectious disease specialists, narcologists and primary health care.
Keywords: 
infectious diseases
phthisiology
tuberculosis
HIV-infection
co-morbidity
mortality
multidrug resistance
drug-addiction.

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