Justification of the integrated approach to management of HIV-infected patients with comorbid pathology of the digestive system

Introduction. Among the main strategic and operational goals of the State Strategy for Combating HIV / AIDS, Tuberculosis and Viral Hepatitis by 2030 in Ukraine is to ensure comprehensive access to HIV treatment, increase the effectiveness of monitoring and support of treatment of both opportunisti...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Olga Holubovska, Volodymyr Vysotskyi
Formato:	article
Lenguaje:	EN UK
Publicado:	Private Publisher "Chaban O.S." 2020
Materias:	HIV infection pathology of the digestive system family medicine Therapeutics. Psychotherapy RC475-489
Acceso en línea:	https://doaj.org/article/fab9543021634fe0bea1aadccc617054
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:fab9543021634fe0bea1aadccc617054
record_format	dspace
spelling	oai:doaj.org-article:fab9543021634fe0bea1aadccc6170542021-11-17T08:35:31ZJustification of the integrated approach to management of HIV-infected patients with comorbid pathology of the digestive system10.26766/pmgp.v5i2.2592519-8572https://doaj.org/article/fab9543021634fe0bea1aadccc6170542020-05-01T00:00:00Zhttp://localhost:8000/index.php/psp/article/view/259https://doaj.org/toc/2519-8572 Introduction. Among the main strategic and operational goals of the State Strategy for Combating HIV / AIDS, Tuberculosis and Viral Hepatitis by 2030 in Ukraine is to ensure comprehensive access to HIV treatment, increase the effectiveness of monitoring and support of treatment of both opportunistic infections and other somatic conditions in HIV-infected patients. The key role of family physicians in the detection and treatment of many chronic gastrointestinal complications in HIV-infected patients is recognized. Purpose of the study. To increase the efficiency of early diagnosis and tactics of integrated management of HIV-infected patients of family physicians (FP) by clarifying the peculiarities of HIV infection in the presence of comorbid pathology of the digestive system (DS) and creating an algorithm for providing medical care to these patients. Material and methods. The research was conducted on the basis of five regional HIV / AIDS centers of Ukraine during 2017-2019. Randomly selected 342 adult HIV-infected patients were divided into two groups - with concomitant lesions and without concomitant gastrointestinal lesions. The following research methods were used: general clinical and laboratory biochemical, molecular genetic, immunological, enzyme-linked immunosorbent, instrumental (FGDS, chest radiography, abdominal ultrasound, computed tomography of the chest and / or abdominal cavity), analysis of primary medical records, consultations related specialists according to the indications, questionnaires, statistical methods. Results and discussion. It was found that the incidence of gastrointestinal pathology in patients with II, III and IV clinical stages of HIV infection was significantly higher than in patients with stage I, significantly more often associated with tuberculosis, candidiasis, kidney disease and HIV encephalopathy and was combined. Manifestations of asthenovegetative and dyspeptic syndromes, weight loss, anemia and leukopenia, increased activity of liver enzymes, low levels of CD4 + lymphocytes and preservation of viral load on antiretroviral therapy were significantly more common in HIV-infected patients with gastrointestinal pathology. In the presence of pathology of the digestive system, replacements, breaks and side effects of antiretroviral therapy were significantly more frequent. The results of physicians survey analysis showed the role of family physicians in the current examination and management of HIV-infected people with comorbid pathology of the digestive system. Conclusions. To detect diseases of the organs of the DS in HIV-infected people, it is necessary to conduct a comprehensive laboratory and instrumental examination, taking into account the possibility of combined pathology. The proposed algorithm of integrated management of HIV-infected patients with comorbid pathology of DS by FPs, taking into account the most informative clinical and laboratory criteria, allows to increase the effectiveness of early diagnosis and tactics of integrated management of HIV-infected by FPs. Olga HolubovskaVolodymyr VysotskyiPrivate Publisher "Chaban O.S."articleHIV infectionpathology of the digestive systemfamily medicineTherapeutics. PsychotherapyRC475-489ENUKPsihosomatična Medicina ta Zagalʹna Praktika , Vol 5, Iss 2 (2020)
institution	DOAJ
collection	DOAJ
language	EN UK
topic	HIV infection pathology of the digestive system family medicine Therapeutics. Psychotherapy RC475-489
spellingShingle	HIV infection pathology of the digestive system family medicine Therapeutics. Psychotherapy RC475-489 Olga Holubovska Volodymyr Vysotskyi Justification of the integrated approach to management of HIV-infected patients with comorbid pathology of the digestive system
description	Introduction. Among the main strategic and operational goals of the State Strategy for Combating HIV / AIDS, Tuberculosis and Viral Hepatitis by 2030 in Ukraine is to ensure comprehensive access to HIV treatment, increase the effectiveness of monitoring and support of treatment of both opportunistic infections and other somatic conditions in HIV-infected patients. The key role of family physicians in the detection and treatment of many chronic gastrointestinal complications in HIV-infected patients is recognized. Purpose of the study. To increase the efficiency of early diagnosis and tactics of integrated management of HIV-infected patients of family physicians (FP) by clarifying the peculiarities of HIV infection in the presence of comorbid pathology of the digestive system (DS) and creating an algorithm for providing medical care to these patients. Material and methods. The research was conducted on the basis of five regional HIV / AIDS centers of Ukraine during 2017-2019. Randomly selected 342 adult HIV-infected patients were divided into two groups - with concomitant lesions and without concomitant gastrointestinal lesions. The following research methods were used: general clinical and laboratory biochemical, molecular genetic, immunological, enzyme-linked immunosorbent, instrumental (FGDS, chest radiography, abdominal ultrasound, computed tomography of the chest and / or abdominal cavity), analysis of primary medical records, consultations related specialists according to the indications, questionnaires, statistical methods. Results and discussion. It was found that the incidence of gastrointestinal pathology in patients with II, III and IV clinical stages of HIV infection was significantly higher than in patients with stage I, significantly more often associated with tuberculosis, candidiasis, kidney disease and HIV encephalopathy and was combined. Manifestations of asthenovegetative and dyspeptic syndromes, weight loss, anemia and leukopenia, increased activity of liver enzymes, low levels of CD4 + lymphocytes and preservation of viral load on antiretroviral therapy were significantly more common in HIV-infected patients with gastrointestinal pathology. In the presence of pathology of the digestive system, replacements, breaks and side effects of antiretroviral therapy were significantly more frequent. The results of physicians survey analysis showed the role of family physicians in the current examination and management of HIV-infected people with comorbid pathology of the digestive system. Conclusions. To detect diseases of the organs of the DS in HIV-infected people, it is necessary to conduct a comprehensive laboratory and instrumental examination, taking into account the possibility of combined pathology. The proposed algorithm of integrated management of HIV-infected patients with comorbid pathology of DS by FPs, taking into account the most informative clinical and laboratory criteria, allows to increase the effectiveness of early diagnosis and tactics of integrated management of HIV-infected by FPs.
format	article
author	Olga Holubovska Volodymyr Vysotskyi
author_facet	Olga Holubovska Volodymyr Vysotskyi
author_sort	Olga Holubovska
title	Justification of the integrated approach to management of HIV-infected patients with comorbid pathology of the digestive system
title_short	Justification of the integrated approach to management of HIV-infected patients with comorbid pathology of the digestive system
title_full	Justification of the integrated approach to management of HIV-infected patients with comorbid pathology of the digestive system
title_fullStr	Justification of the integrated approach to management of HIV-infected patients with comorbid pathology of the digestive system
title_full_unstemmed	Justification of the integrated approach to management of HIV-infected patients with comorbid pathology of the digestive system
title_sort	justification of the integrated approach to management of hiv-infected patients with comorbid pathology of the digestive system
publisher	Private Publisher "Chaban O.S."
publishDate	2020
url	https://doaj.org/article/fab9543021634fe0bea1aadccc617054
work_keys_str_mv	AT olgaholubovska justificationoftheintegratedapproachtomanagementofhivinfectedpatientswithcomorbidpathologyofthedigestivesystem AT volodymyrvysotskyi justificationoftheintegratedapproachtomanagementofhivinfectedpatientswithcomorbidpathologyofthedigestivesystem
_version_	1718425712005742592

Justification of the integrated approach to management of HIV-infected patients with comorbid pathology of the digestive system

Ejemplares similares