Causes of deaths among HIV-infected persons in the Russian Federation in 2008–2018

Introduction. The HIV epidemic situation in the Russian Federation remains tense. Low coverage of antiretroviral therapy (ART) contributes to the disease progression in some PLHIV. Many authors point to a high prevalence of different secondary disease combinations.Objective. Studying the structure of secondary disease combinations in inpatients and identifying features of immunological and virological indicators.Materials and methods. There was retrospective analysis of 1440 cases of HIV-infected admission in ICU SBHI «ICH № 2» DZM in 2018–2020. The number of CD4+ cells were estimated in 1185 patients, viral load (VL) is defined in 1173 patients.Statistical analysis is held, using program StatTech v. 2.6.2 (developer — LLC «Statech», Russia).Results. 18,5% of patients had 1 secondary disease, 75,9% were diagnosed a combination of 2 and more various lesions. 275 different combinations of secondary diseases are recorded: from 50 combinations of 2 secondary lesions to 4 combinations of 7 nosological units. Ме VL in patients with no secondary diseases — 13 303 copies/ml, with 1 secondary disease it increased 3,2 times (42 926) (p<0,001). Similar changes are detected with 3, 5 and 6 diseases. Ме number of CD4+ lymphosytes in the absence of a secondary pathology — 223 cells/mcl. As the number of secondary diseases increases from 1 to 4, we observe consistent reduction in the number of CD4+ lymphosytes; in a combined secondary pathology Ме CD4+ cells did not exceed 100 cells; with 4 and more secondary diseases this figure did not exceed 20 cells in mcl. Correlation analysis of CD4+ cells and the number of combined secondary diseases revealed the presence of moderate connection tightness on the Chaddock scale (rxy=0,356, p<0,001). The depth of immunodeficiency also affects the outcome of the disease: (M±SD) CD4+ cells in the group of the dead were 101±153 (95% DI: 91–112), in the group of survivors — 198±226 (95% DI:172–224; p<0,001).Conclusion. Combined secondary disease among patients of ICU infectious hospital were diagnosed in 75.9% patients. There were differences by VL level which increased with the growth of combined lesion number; more significant correlation was found between the amount of CD4+ cells and the number of secondary diseases. The obtained results are confirmed by reduced likelihood of a favorable outcome of the disease with increasing number of combined secondary diseases.

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Immunological and virological features of combined secondary diseases in patients with HIV-based immunodeficiency

Voznesenskiy

Кожевникова

Ermak

et al. 2022

VIČ-infekc. immunosupr.

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Clinical and immunological characteristics of opportunistic infections in children with the natural course of HIV infection, taking into account the route of infection

Денисенко

Simovanyan

2022

Det. infekc.

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The purpose of the study is to improve the diagnosis and prognosis of opportunistic infections in children infected with HIV by vertical and parenteral routes, taking into account the dynamics of clinical and immunological parameters.Research methods. Clinical and laboratory examinations were carried out in 192 children infected with HIV by the vertical route (91; group I), parenteral route in infancy (44; group II) and over the age of one year (57; group III).Research results. In group I, a rapid development of immunosuppression was observed: mild immunodeficiency was diagnosed at the age of Me 4 (IQI 2—10) months, advanced immunodeficiency — Me 11 ( IQI 6—24.5) months, severe immunodeficiency — Me 23 ( IQI 11— 56) months. Clinical manifestation of opportunistic infections occurred in the first three years of life with a relatively high content of CD4-lymphocytes. Localized bacterial infections (Me 27,5; IQI 21,9–34,1/100 MYO), candidiasis (Me 14,1; IQI 10,2—18,9 / 100 MYO) and generalized infections (Me 5,2; IQI 2,9—8,5 / 100 MYO) had the highest relative incidence rate. In group II, there was a slower progression of immunosuppression (within one to seven years), the addition of opportunistic infections with a lower content of CD4-lymphocytes, in terms of one to nine years, a high relative incidence of herpes simplex infection (Me 12,9; IQI 7,8—14,9 / 100 MYO), herpes zoster (Me 3; IQI 1,5—5,4 / 100 MYO) and pneumocystosis (Me 3,8; IQI 2,1—6,4 / 100 MYO). In group III, there was a slow progression of immunosuppression (within one to eight years), the development of opportunistic infections with a low content of CD4-lymphocytes, in terms of two to ten years, a rarer manifestation of most diseases.Conclusion. These patterns should be taken into account when planning diagnostic, therapeutic and preventive measures in children with HIV infection, taking into account the path and age at the time of infection.

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Causes of deaths among HIV-infected persons in the Russian Federation in 2008–2018

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Immunological and virological features of combined secondary diseases in patients with HIV-based immunodeficiency

Immunological and virological features of combined secondary diseases in patients with HIV-based immunodeficiency

Clinical and immunological characteristics of opportunistic infections in children with the natural course of HIV infection, taking into account the route of infection

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