Epidemiological analysis of factors influencing the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis

The epidemiological significance of combined forms of especially dangerous infections has not been studied enough, unlike mono-infections. Currently, there is a tendency towards an increase in the incidence of multidrug-resistant tuberculosis. The formation of severe forms of the disease is caused b...

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Autores principales:	A. V. Kukurika, E. I. Yourovskaya, V. A. Lyakhimets
Formato:	article
Lenguaje:	RU
Publicado:	Sankt-Peterburg : NIIÈM imeni Pastera 2021
Materias:	multidrug-resistant tuberculosis hiv-infection viral hepatitis factors anti-tuberculosis drugs antiretroviral therapy Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/09553ac8b7ce4b8e89f0ec5854f22562
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spelling	oai:doaj.org-article:09553ac8b7ce4b8e89f0ec5854f225622021-11-22T07:09:55ZEpidemiological analysis of factors influencing the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis2220-76192313-739810.15789/2220-7619-EAO-1504https://doaj.org/article/09553ac8b7ce4b8e89f0ec5854f225622021-11-01T00:00:00Zhttps://www.iimmun.ru/iimm/article/view/1504https://doaj.org/toc/2220-7619https://doaj.org/toc/2313-7398The epidemiological significance of combined forms of especially dangerous infections has not been studied enough, unlike mono-infections. Currently, there is a tendency towards an increase in the incidence of multidrug-resistant tuberculosis. The formation of severe forms of the disease is caused by other widespread infections, such as chronic viral hepatitis and HIV. Polymorbid conditions distort the clinical manifestations of tuberculosis, reduce the effectiveness of anti-tuberculosis therapy and worsen the prognosis of the disease. Risk factors among patients in this category need analysis to carefully monitor patients and ensure infection control. Objective is to analyze the factors affecting the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis. Materials and methods. Cases of the combined pathology of multiresistant tuberculosis, HIV infection and viral hepatitis with a dominant diagnosis of tuberculosis are analyzed. Results and discussion. The influence of the immunological status on the course of combined pathology was revealed. Since all the patients under study had clinical stage 4 of HIV infection, tuberculosis developed as an opportunistic infection. Severe immunosuppression (CD4 < 200 cells/ml) contributed to the progression of the generalized tuberculosis process. Long-term immunodeficiency was an unfavorable factor; in the overwhelming majority of cases, antiretroviral therapy was prescribed only after tuberculosis was detected. The dependence of the clinical form of tuberculosis on the level of CD4-lymphocytes was noted: isolated lesion of the chest organs prevailed in patients with a level of CD4-lymphocytes more than 200 cells/ml, generalization of TB process — with CD4 less than 200 cells/ml. Patients with miliary tuberculosis had a higher mortality rate compared to patients with other clinical forms, regardless of antiretroviral therapy. It was revealed that socially disoriented young people with viral hepatitis C prevailed in the structure of patients, the prevalence of which was due to the influence of aggravating factors, such as alcohol and drug abuse, and stay in prisons. Against the background of combined treatment, there was no significant effect of viral hepatitis on the course of polymorbid conditions and the effectiveness of the therapy.A. V. KukurikaE. I. YourovskayaV. A. LyakhimetsSankt-Peterburg : NIIÈM imeni Pasteraarticlemultidrug-resistant tuberculosishiv-infectionviral hepatitisfactorsanti-tuberculosis drugsantiretroviral therapyInfectious and parasitic diseasesRC109-216RUInfekciâ i Immunitet, Vol 11, Iss 5, Pp 989-993 (2021)
institution	DOAJ
collection	DOAJ
language	RU
topic	multidrug-resistant tuberculosis hiv-infection viral hepatitis factors anti-tuberculosis drugs antiretroviral therapy Infectious and parasitic diseases RC109-216
spellingShingle	multidrug-resistant tuberculosis hiv-infection viral hepatitis factors anti-tuberculosis drugs antiretroviral therapy Infectious and parasitic diseases RC109-216 A. V. Kukurika E. I. Yourovskaya V. A. Lyakhimets Epidemiological analysis of factors influencing the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis
description	The epidemiological significance of combined forms of especially dangerous infections has not been studied enough, unlike mono-infections. Currently, there is a tendency towards an increase in the incidence of multidrug-resistant tuberculosis. The formation of severe forms of the disease is caused by other widespread infections, such as chronic viral hepatitis and HIV. Polymorbid conditions distort the clinical manifestations of tuberculosis, reduce the effectiveness of anti-tuberculosis therapy and worsen the prognosis of the disease. Risk factors among patients in this category need analysis to carefully monitor patients and ensure infection control. Objective is to analyze the factors affecting the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis. Materials and methods. Cases of the combined pathology of multiresistant tuberculosis, HIV infection and viral hepatitis with a dominant diagnosis of tuberculosis are analyzed. Results and discussion. The influence of the immunological status on the course of combined pathology was revealed. Since all the patients under study had clinical stage 4 of HIV infection, tuberculosis developed as an opportunistic infection. Severe immunosuppression (CD4 < 200 cells/ml) contributed to the progression of the generalized tuberculosis process. Long-term immunodeficiency was an unfavorable factor; in the overwhelming majority of cases, antiretroviral therapy was prescribed only after tuberculosis was detected. The dependence of the clinical form of tuberculosis on the level of CD4-lymphocytes was noted: isolated lesion of the chest organs prevailed in patients with a level of CD4-lymphocytes more than 200 cells/ml, generalization of TB process — with CD4 less than 200 cells/ml. Patients with miliary tuberculosis had a higher mortality rate compared to patients with other clinical forms, regardless of antiretroviral therapy. It was revealed that socially disoriented young people with viral hepatitis C prevailed in the structure of patients, the prevalence of which was due to the influence of aggravating factors, such as alcohol and drug abuse, and stay in prisons. Against the background of combined treatment, there was no significant effect of viral hepatitis on the course of polymorbid conditions and the effectiveness of the therapy.
format	article
author	A. V. Kukurika E. I. Yourovskaya V. A. Lyakhimets
author_facet	A. V. Kukurika E. I. Yourovskaya V. A. Lyakhimets
author_sort	A. V. Kukurika
title	Epidemiological analysis of factors influencing the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis
title_short	Epidemiological analysis of factors influencing the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis
title_full	Epidemiological analysis of factors influencing the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis
title_fullStr	Epidemiological analysis of factors influencing the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis
title_full_unstemmed	Epidemiological analysis of factors influencing the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis
title_sort	epidemiological analysis of factors influencing the course of multidrug-resistant tuberculosis in hiv-infected patients with concomitant viral hepatitis
publisher	Sankt-Peterburg : NIIÈM imeni Pastera
publishDate	2021
url	https://doaj.org/article/09553ac8b7ce4b8e89f0ec5854f22562
work_keys_str_mv	AT avkukurika epidemiologicalanalysisoffactorsinfluencingthecourseofmultidrugresistanttuberculosisinhivinfectedpatientswithconcomitantviralhepatitis AT eiyourovskaya epidemiologicalanalysisoffactorsinfluencingthecourseofmultidrugresistanttuberculosisinhivinfectedpatientswithconcomitantviralhepatitis AT valyakhimets epidemiologicalanalysisoffactorsinfluencingthecourseofmultidrugresistanttuberculosisinhivinfectedpatientswithconcomitantviralhepatitis
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Epidemiological analysis of factors influencing the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis

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