Videoendosurgical techniques in diagnosis of chest diseases in HIV patients

Synitsyn, M. V.; Reshetnikov, M. N.; Sokolina, Irina; Плоткин, Д. В.; VIRSKIY, N. YU.; Barskiy, Boris

doi:10.17116/endoskop201723217-22

Cited by 4 publications

(1 citation statement)

References 16 publications

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“…showed that chest radiography (CXR) can be used to screen for evidence of subclinical TB, but is insensitive. Mycobacterium tuberculosis (bacteriological and molecular genetic), computed tomography, and, if necessary, invasive diagnostic tests to confirm the diagnosis, which allowed confirming or ruling out active tuberculosis in individuals with a positive Diaskintest and provide the identification of TB patients in the early stages of the disease[47].After the differential diagnosis of tuberculosis and LTBI was carried out in subjects who had a positive Diaskintest reaction, all people with LTBI were prescribed preventive therapy. Since HIV-infected patients with reduced CD4+ counts have an increased proportion of negative test results in the presence of tuberculosis infection, preventive therapy is prescribed when the number of these cells is less than 350[48,49] even in patients with a negative Diaskintest reaction.…”

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The effectiveness of prevention and early detection of tuberculosis in people living with HIV

Sinitsyn¹,

Belilovsky²,

Bogorodskaya³

et al. 2020

Preprint

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AbstractBackgroundThe difficult epidemic situation caused by TB/HIV co-infection and, accordingly, the need to strengthen measures for the prevention of tuberculosis among HIV patients, identified the need to create a model of collaborating tuberculosis management facilities and AIDS centers.Study purposeanalysis of the effectiveness of measures used in Moscow to prevent the spread of HIV/tuberculosis co-infection based on the developed new algorithm.Materials and methodsThe design of the study – a full-design retrospective cohort study of all HIV patients in tuberculosis preventive care and early detection unit for HIV patients (PCED TB Unit), which was organized in 2014 as a subdivision of Moscow TB Center on the premises of the Moscow AIDS Center. The study was conducted from 2014 to 2017. 22,190 HIV-infected patients were examined. In order to detect tuberculosis infection, all HIV patients were referred for skin testing with preparation Diaskintest, which represents recombinant proteins CFP10-ESAT6 and persons with a positive and doubtful reaction were examined for the diagnosis of tuberculosis and latent tuberculosis infection (LTBI). Preventive therapy (PT) was prescribed to patients with LTBI, which was also received by those with CD4+count ≤350 cells/mm3, regardless of the results of a skin test.ResultsOver a period of 4 years, Diaskintest was performed in 19,777 people. Positive results were in 857 patients (4.3%) [95% CI 4.1-4.6]. 131 patients were diagnosed with tuberculosis, the rest - with LTBI. The effectiveness of PT was estimated by the number of TB cases detected among HIV patients who completed PT (1757) and those who did not receive it (5990). The notification rate of TB in the first group was 228 [95%CI 65-582] per 100,000 patients, in the second 1486 [95%CI 1195–1825], which is 6,5 times higher. To assess the effectiveness of early detection of TB, the proportion of severity forms of pulmonary TB diagnosed in 87 patients at the PCED TB Unit using a new algorithm in 2016-2017 were compared with 411patients detected in different medical organizations of Moscow using conventional methods. The proportion of disseminated TB was lower in the first group (23.0% versus 44.5%) (p<0.01).ConclusionThe study showed that the integration of the two services allows increases the accessibility of TB care and makes a significant contribution to improving the effectiveness of measures to prevent the TB spread among HIV patients. It supports the necessity of treating LTBI detected using the Diaskintest to prevent TB in HIV-infected patients. Significant effects that have been achieved include a reduction in the TB notification rate among HIV patients, improvement of the diagnostic structure of registered TB cases as a result of their timely detection.

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confidence: 99%

The effectiveness of prevention and early detection of tuberculosis in people living with HIV

Sinitsyn¹,

Belilovsky²,

Bogorodskaya³

et al. 2020

Preprint

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Surgical Treatment of Tuberculosis in Hiv Patients

Синицын¹,

VIRSKIY²,

TITYUKHINА³

et al. 2018

TaLD

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ГБУЗ «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы», Москва, Россия Цель исследования: изучение результатов хирургического лечения туберкулеза у больных ВИЧ-инфекцией� Материалы и методы. Проанализированы результаты хирургического лечения 345 больных ВИЧ-инфекцией и туберкулезом органов дыхания, им выполнено 355 операций� Небольшие вмешательства (189/355; 53,2%) выполнены как срочные у 181 пациента, в основном с низким иммунным статусом� Плановые операции (166/355; 46,8%) выполнены у 164 пациентов, в основном по поводу туберкулеза или его осложнений� Результаты. У 345 прооперированных пациентов было 2,0% послеоперационных осложнений, связанных с операцией, 1,2% осложнений, не связанных напрямую с хирургическим вмешательством, 0,9% летальных исходов� Резекционные операции были успешно выполнены и у пациентов, не получавших антиретровирусную терапию при низком иммунном статусе� Все 3 случая летальных исходов были у пациентов с уровнем CD4 SURGICAL TREATMENT OF TUBERCULOSIS IN HIV PATIENTS M. V. SINITSYN, N. YU. VIRSKIY, M. V. TITYUKHINА, B. G. BАRSKIY, T. I. АBU АRKUB, M. V. KАLININА Moscow Municipal Scientific Practical Center of Tuberculosis Control, Moscow, RussiaThe objective of the study: to study the outcomes of surgical treatment of tuberculosis in HIV patients� Subjects and methods. Surgery outcomes in 345 HIV patients with respiratory tuberculosis were analyzed; totally, 355 surgeries were performed on them� Minor surgeries (189/355; 53�2%) done due to emergency reasons were performed in 181 patients, mostly in those with severe immune suppression� 164 patients had planned surgeries (166/355; 46�8%) mostly due to tuberculosis and its complications� Results. In 345 operated patients, post-operative complications related to surgery made 2�0%, complications not related directly to surgery made 1�2%, and lethal outcomes made 0�9%� Surgery resections were successful even in the patients receiving no antiretroviral therapy with severe immune suppression� All 3 lethal outcomes occurred in the patients with CD4+ count below 200 cell/mcl and they made 2�3% among such patients� /2075-1230-2018-96-7-18-24 Современная эпидемическая ситуация характе-ризуется постоянным увеличением числа больных ВИЧ-инфекцией [7, 10]� Это связано как с регистра-цией новых случаев заболевания, так и с продлени-ем срока жизни пациентов в результате широкого применения антиретровирусной терапии (АРТ) [1, 2]� Неуклонное прогрессирование ВИЧ-инфек-ции сопровождается присоединением вторичных заболеваний, которые часто и определяют длитель-ность жизни пациентов� Одним из наиболее часто встречающихся вторичных заболеваний является туберкулез, риск развития туберкулеза у больных ВИЧ-инфекцией в 20-37 раз выше, чем у ВИЧ-не-гативных лиц [9]� Необходимость хирургического лечения тубер-кулеза у больных ВИЧ-инфекцией возникает при недостаточной эффективности противотуберкулез-ной химиотерапии или при осложненном течении заболевания� Наиболее часто это случается при туберкулезе ...

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Biomarkers and immunological tests. Experimental and clinical parallels of latent tuberculosis infection

Кудлай

2020

Tuberk. bolezni lëgk.

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The article presents the review of 94 publications. It describes experiments on latent tuberculosis infection on Cynomolgus macaques. It has been noted that in recent years, PET-CT has been used to identify thoracic lymph nodes (LN) infected with Mycobacterium tuberculosis (MTB). It has been demonstrated that FDG-PET-CT allows concluding about the presence of viable MTB in thoracic LNs in case of latent tuberculosis infection which is confirmed by detection of live MTB in granulomas of these LNs by culture. The preventive therapy contributes to a significant reduction of pathology visible on PET-CT. The review analyzes publications that experimentally show the spectrum of the immune response to MTB-specific proteins ESAT-6 and CFP10 in case of tuberculosis infection, in particular, the relationship between the cytokine response and bacterial load.

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Videoendosurgical techniques in diagnosis of chest diseases in HIV patients

Cited by 4 publications

References 16 publications

The effectiveness of prevention and early detection of tuberculosis in people living with HIV

The effectiveness of prevention and early detection of tuberculosis in people living with HIV

Surgical Treatment of Tuberculosis in Hiv Patients

Biomarkers and immunological tests. Experimental and clinical parallels of latent tuberculosis infection

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