Effectiveness of treatment of lung tuberculosis in hiv-infected patients

Introduction: Persons infected with both HIV and tuberculosis are particularly at high risk. The annual probability of developing tuberculosis in them is 5-10%, while in the other contingent population this probability does not exceed 10% throughout life. The combination of these two diseases worsens the prognosis of the course of the disease and the outcomes of the treatment of patients, determines the features in the clinical and radiological picture.

The aim of the study was to study the outcomes of the treatment of pulmonary tuberculosis in HIV-infected patients. Materials and methods: a retrospective analysis of the statistical report of the regional TB dispensary was conducted for year 2017 .

Results and discussion: For the period of 2015-2017, there were 144 patients with tuberculosis associated with HIV or 2.8% of the total contingent of adult patients with active pulmonary tuberculosis in the oblast. The work carried out made it possible to establish that the number of such patients increased by 1.4 times (2015-2017).

Treatment of patients with a combination of HIV infection and pulmonary tuberculosis was carried out in the regional TB dispensary in accordance with the orders of the Ministry of Health of the Republic of Kazakhstan for the DOTS and DOTS-plus strategy, then outpatient, at the place of residence. When analyzing the effectiveness of treatment for cases of "recovery", we included those patients who, in addition to the conversion of the smear, noted the closure of the decay cavities, confirmed by X - ray and tomography studies. With the preservation of destruction, the results of chemotherapy were recorded as "treatment completed". The analysis does not include patients who arbitrarily interrupted treatment (three people), transferred to other institutions (two people) and continuing therapy (twenty-five patients). The effectiveness of treatment was performed in comparison of recurrent tuberculosis and for the first time detected in combination with HIV infection.

The analysis shows a low recovery rate of 40.9%, and in case of recurrent pulmonary tuberculosis it is almost two times less (9.7%) than in the new cases (4.8%). Mortality in relapses 33 (22,9%) exceeds that in newly diagnosed patients with double infection (4,8%) by 2,3 times. The main causes of death were the progression of the tuberculous process in the lungs.

Conclusion: Thus, a low percentage of recovery (40.9%) after treatment of recurrence of pulmonary tuberculosis in the context of HIV infection requires additional measures to intensify tuberculosis work. When dispensary observation of persons with HIV - infected, past TB disease, it is necessary to conduct fluoroscopes twice a year in order to detect and early treat tuberculosis earlier.

Year: 2018
City: Shymkent
Category: Medicine