Features of clinical manifestations and diagnostics of pulmonary tuberculosis and opportunistic lung infections combination in adult patients with advanced HIV infection and immunodeficiency

Мишина, А. В.; Мишин, В. Ю.; Ergeshov, Atadzhan; Sobkin, A. L.; Romanov, Vladimir; Kononets, Aleksandr S.

doi:10.26442/20751753.2020.11.200184

Cited by 4 publications

(4 citation statements)

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“…For diagnostics of opportunistic infections of the lungs associated with Candida albicans 1 type (C. albicans), Mycobacterium nontuberculosis (M. nontuberculosis), Pneumocystis jiroveci (P. jiroveci), Herpes simplex virus (HVS) and Cytomegalovirus hominis (CMVH), viral, bacterial, immunological and molecular-genetic studies were used (polymerase chain reaction -PCR) of the diagnostic material from the respiratory tract [9,20,26,31].…”

Section: Methodsmentioning

confidence: 99%

“…We pay special attention to the lung damages caused immediately by HIV-infection manifesting in lymphoid and non-specific interstitial pneumonia. High incidence and advance of chronic obstructive lung disease (COLD), which in its case makes conditions for development of bacterial pneumonia [9,26,31]. Also, for the first time the complexity issues for etiological diagnostics of comorbid abnormality using the complex of modern laboratory and instrumental methods are being discussed as they have not been studied at all.…”

Section: Introductionmentioning

confidence: 99%

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Comorbidity of Pulmonary Tuberculosis and Bacterial Pneumonia in Patients With Late Stages of Hiv-Infection With Immunodeficiency

Мишина

Мишин

Shashenkov

2022

Preprint

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Purpose. To study specifics of diagnostics and clinics of comorbidity of pulmonary tuberculosis and bacterial pneumonia in patients with HIV-infection with immunodeficiency. Materials and methods. Ninety-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 1st group included 31 patient with pulmonary tuberculosis and pneumonia associated with Streptococcus pneumoniae, the 2nd group included 31 patient with pulmonary tuberculosis and pneumonia associated with Staphylococcus aureus. The 3rd group 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). Results. Comorbidity of pulmonary tuberculosis and pneumonia associated with S. pneumoniae or S. aureus in 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 of M. tuberculosis and 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. Conclusion. Clinical signs and X-ray changes in combination of pulmonary tuberculosis and pneumonia associated with S. pneumoniae or S. aureus and 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. Key words: comorbidity, tuberculosis of the respiratory system, bacterial pneumonia, HIV-infection, immunodeficiency, opportunistic infections of the lungs, drug resistance.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comorbidity of Pulmonary Tuberculosis and Bacterial Pneumonia in Patients With Late Stages of Hiv-Infection With Immunodeficiency

Мишина

Мишин

Shashenkov

2022

Preprint

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“…Infectious lung damage of various etiologies is one of the main causes of pneumonia in patients with HIV infection especially in the late stages with immunodeficiency [1-5]. An important role in this category of patients plays tuberculosis if combined with other opportunistic lung infections [6] among which important is a viral pneumonia (VP) etiologically associated with Herpesvirus Simplex of type 1 (HVS-1) and Human Cytomegalovirus (CMVH) that significantly affects the severity of clinical manifestation and the therapy efficacy because of absence of specific treatment [7-12]…”

Section: Rationalementioning

confidence: 99%

“…Infectious lung damage of various etiologies is one of the main causes of pneumonia in patients with HIV infection especially in the late stages with immunodeficiency [1][2][3][4][5]. An important role in this category of patients plays tuberculosis if combined with other opportunistic lung infections [6] among which important is a viral pneumonia (VP) etiologically associated with Herpesvirus Simplex of type 1 (HVS-1) and Human Cytomegalovirus (CMVH) that significantly affects the severity of clinical manifestation and the therapy efficacy because of absence of specific treatment [7][8][9][10][11][12] COVID-19 has created certain problems in HIV-infected patients due to severe damage to the respiratory system and development of coronavirus pneumonia (CVP) which is one of the main reasons for hospitalization of HIV-infected patients and the most common cause of their death [13][14][15][16][17]. However, the greatest problems arise in cases of comorbidity of respiratory tuberculosis and herpesvirus pneumonia (HVP) caused by HVS-1, cytomegalovirus pneumonia (CMVP) caused by CMVH and CVP caused by SARS-CoV-2 in patients with late-stage HIV infection with immunodeficiency in terms of clinical and radiological manifestations and timely diagnosis for selection of adequate etiological treatment and anti-epidemic measures.…”

Section: Rationalementioning

confidence: 99%

Clinical pattern and diagnostic of comorbidity of respiratory tuberculosis and viral pneumonia caused by Herpesvirus Simplex, Human Cytomegalovirus and SARS-CoV-2 in patients with late-stage HIV infection with immunodeficiency

Mishin,

Mishina,

Shashenkov

2023

Preprint

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Aim. To study features of social status, clinical pattern and diagnosis in cases of comorbidity of respiratory tuberculosis and viral pneumonia caused by Herpesvirus Simplex of type 1, Human Cytomegalovirus and SARS-CoV-2 in patients with late-stage HIV infection with immunodeficiency. Materials and methods. The prospective study included 25 patients with comorbid condition of respiratory tuberculosis with Mycobacterium tuberculosis in excreta, herpesvirus and coronavirus pneumonia, and 21 patients with respiratory tuberculosis as well as cytomegalovirus and coronavirus pneumonia (1a and 2a main groups) and, respectively, 25 and 21 similar patients, but without coronavirus pneumonia (1b and 2b comparison group) in the late stages of HIV infection with immunodeficiency. For the etiological diagnosis of herpesvirus and cytomegalovirus pneumonia, the PCR test was used for recognition of DNA of Herpesvirus Simplex of type 1 and Human Cytomegalovirus in the diagnostic material of respiratory tract and for the etiological diagnosis of coronavirus pneumonia, the PCR for recognition of RNA was used to reveal SARS-CoV-2. Statistical analysis of the data was performed by the use of the Microsoft Office Excel 2019 software for calculation of group mean, standard error of mean and confidence interval. Results. The comorbidity of respiratory tuberculosis, herpes-, cytomegalo- and coronavirus pneumonia in patients with late-stage HIV infection in the phase of progression and in the absence of ART was characterized by severe immunodeficiency and generalization of tuberculosis with multiple extrapulmonary lesions. The results displayed similarity of clinical manifestations and visualization of changes in CT-picture in cases of comorbidity the diseases which hampers their recognition due to simultaneous combination of several pathologies with similar clinical manifestations that requires a complex etiological diagnosis of the specific diseases to prescribe a timely comprehensive treatment and reduce lethality in this severe contingent of patients. Conclusion. Patients with respiratory tuberculosis and HIV infection registered in the office of tuberculosis care for HIV-infected individuals in the antituberculosis dispensary represent a group of high risk from COVID-19 infection and CVP disease, and, in cases of combination with severe immunodeficiency, HVP and CMVP, the patients should be regularly subjected to preventive studies for timely detection of COVID-19 for the purpose of their emergency isolation and treatment.

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The effect of a new coronavirus infection (COVID-19) on clinical and radiological manifestations in patients with comorbidity of respiratory tuberculosis, HIV-infection and opportunistic lung diseases: prospective study design

et al. 2022

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Aim. To study the features of clinical and radiological manifestations and diagnosis of COVID-19, respiratory tuberculosis and opportunistic lung infections (OIL) coinfection in patients with late stages of HIV-infection with immunodeficiency. Materials and methods. The study included 29 patients with COVID-19 coinfection, respiratory tuberculosis and opportunistic lung infections in the late stages of HIV-infection with immunodeficiency (group 1) and 29 patients similar in all parameters without COVID-19 (group 2). All patients were underwent clinical and laboratory, radiation and bronchological examination, and microbiological, immunological, molecular genetic, cytological and histological examination of diagnostic material of the respiratory tract, cerebrospinal and pleural fluid, blood, urine and feces to identify pathogens of coinfection. Statistical data processing was carried out using the Microsoft Office Excel 2010 program with the calculation of the average in the group and the standard error of the average, confidence interval. Results. It has been established that co-infection with COVID-19, respiratory tuberculosis and opportunistic lung infections in patients with late stages of HIV-infection with immunodeficiency is manifested by a pronounced intoxication syndrome, bronchopulmonary manifestations and symptoms of damage to other organs and systems, which is due to the generalization of tuberculosis with extrapulmonary lesions and the development of opportunistic lung infections, as in patients without COVID-19. A computed tomogram of the chest organs with this coinfection visualizes the syndrome of dissemination, the syndrome of adenopathy and the syndrome of pathology of the pulmonary pattern, represented by the compaction of interstitial tissue in the frosted glass type, which is associated with the simultaneous layering of various pathologies, which complicates their differential diagnosis. This determines the similarity of clinical and radiological manifestations of COVID-19 coinfection, respiratory tuberculosis and opportunistic lung infections in patients with late-stage HIV-infection with immunodeficiency, as in patients without COVID-19. This requires complex microbiological and molecular genetic research methods to identify specific pathogens for the appointment of timely treatment. Conclusion. Patients with COVID-19 coinfection, respiratory tuberculosis and opportunistic lung infections in the late stages of HIV-infection with immunodeficiency pose a high risk of infection in a healthy population, taking into account their social maladaptation and non-adherence to examination and treatment. This requires an active diagnosis of COVID-19 in all patients with respiratory tuberculosis and HIV-infection who are registered in the office of anti-tuberculosis care for HIV-infected in an anti-tuberculosis dispensary, for emergency isolation and treatment.

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Features of clinical manifestations and diagnostics of pulmonary tuberculosis and opportunistic lung infections combination in adult patients with advanced HIV infection and immunodeficiency

Cited by 4 publications

References 0 publications

Comorbidity of Pulmonary Tuberculosis and Bacterial Pneumonia in Patients With Late Stages of Hiv-Infection With Immunodeficiency

Comorbidity of Pulmonary Tuberculosis and Bacterial Pneumonia in Patients With Late Stages of Hiv-Infection With Immunodeficiency

Clinical pattern and diagnostic of comorbidity of respiratory tuberculosis and viral pneumonia caused by Herpesvirus Simplex, Human Cytomegalovirus and SARS-CoV-2 in patients with late-stage HIV infection with immunodeficiency

The effect of a new coronavirus infection (COVID-19) on clinical and radiological manifestations in patients with comorbidity of respiratory tuberculosis, HIV-infection and opportunistic lung diseases: prospective study design

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