Viral, but not-COVID pneumonia in patients with HIV infection

Shakhgildyan, Shakhgildyan V.I.; Yadrikhinskaya, Yadrikhinskaya M.S.; Orlovsky, Orlovsky A.A.; E, Domonova E.A. Domonova; Shipulina, Shipulina O.Yu.; Tishkevich, Tishkevich O.A.; Ermak, Ermak T.N.; Yarovaya, Yarovaya E.B.

doi:10.18565/epidem.2021.11.3.69-77

Cited by 2 publications

(2 citation statements)

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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%

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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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