Search

Background. Identification of the characteristics of the pulmonary tuberculosis process using multi-layer spiral computed tomography (MSCT) in patients with tuberculosis and HIV infection is important in the diagnosis of tuberculosis, determining the dissemination of the process and its dynamics during treatment. The aim. To determine the initial characteristics and dynamics of infiltrative tuberculosis according to MSCT in patients with and without HIV infection, with and without multidrug resistance (MDR) of Mycobacterium tuberculosis who were treated in a hospital. Materials and methods. 126 patients aged 19–59 years with tuberculosis, combined with HIV infection and without HIV infection were examined. For statistical processing, we used MS Excel (Microsoft Corp., USA) software package. Results. Patients with tuberculosis and HIV infection in comparison with patients with tuberculosis and without HIV had more expressed intoxication syndrome and respiratory impairement in the clinical picture (p < 0.00001). Patients with coinfection were more likely to suffer from alcohol (p < 0.05) and drug addiction (p < 0.001). According to MSCT, the pathological process in HIV-positive patients with pulmonary tuberculosis was more disseminated (p < 0.05), included severe intrathoracic lymphadenopathy (p < 0.0001), more common pleural lesions (p < 0.005), less common destructive changes (cavities) (p < 0.001) and outcomes in form of fibro-cavernous tuberculosis (p < 0.01). Process regression was slower in patients with tuberculosis and HIV (p < 0.005). According to MSCT, extensive lung damage, intrathoracic lymphadenopathy were more often found in patients with MDR in coinfection (p < 0.05). Cavities and fibro-cavernous tuberculosis outcomes were more common in patients with tuberculosis without HIV infection and with MDR (p < 0.05). Conclusion. MSCT provides detailed information about the pathological process in the lungs and its dynamics under the treatment of tuberculosis and HIV infection.

The objective of the study: to compare clinical, social, and radiological parameters of respiratory tuberculosis in patients with different HIV statuses in the region with a high prevalence of the coinfection.Subjects and Methods. The retrospective study of medical files of 80 patients with pulmonary tuberculosis was conducted; patients were divided into 2 groups, 40 patients each: TB/HIV Group – patients with pulmonary tuberculosis and HIV infection, TB Group – patients with pulmonary tuberculosis and negative HIV status. The groups were comparable by gender and age. The groups were compared with each other by certain parameters.Results. Considering clinical signs, patients from TB/HIV Group suffered from more pronounced intoxication syndrome (χ2 = 10.476; p 200 cell/μl, when CD4 level ≤ 200 cell/μl, the frequency of radiological signs typical of tuberculosis such as alveolar infiltration, destruction of lung tissue decreased in chest CT, while the frequency of atypical manifestations (interstitial changes such as frosted glass) increased.