ETIOLOGICAL VERIFICATION OF TUBERCULOSIS IN CASE OF SYSTEM INFLAMMATORY SYNDROME IN HIV PATIENTS
https://doi.org/10.21292/2075-1230-2019-97-3-26-30
Abstract
The objective: to study the efficacy of etiological verification of tuberculosis in case of systemic inflammation syndrome in HIV patients. Subjects and methods. 116 HIV patients were examined; all of them were admitted to hospital due to systemic inflammatory syndrome (SIS). In order to diagnose tuberculosis, clinical, bacteriological, and instrumental examinations were performed. Specimens of venous blood were used for the detection of tuberculous mycobacteria by RT-PCR and culture. Results. More than half (64.6%) of cases of systemic inflammatory syndrome in the examined HIV patients was due to tuberculosis onset. The degree of immunity suppression (considering CD4 count) in SIS patients with tuberculosis onset and various HIV-associated pathologies was not statistically significantly different. The frequency of MTB DNA detection by RT-PCR in venous blood in case of verified tuberculous sepsis (non-academic term) in TB/HIV patients made 29.3%, and taking into account positive results of blood culture in 5 patients with no MTB DNA found in the blood, the efficiency of diagnosis of tuberculosis in blood specimens reached 33.3%, while efficiency of blood cultures for MTB made 36.0%, with 100% specificity. Repeated PCR tests and blood cultures performed in some patients allowed increasing the total efficiency of blood tests.
About the Authors
K. B. Vladimirov
Medical Unit no. 78, Russian Penitentiary System, St. Petersburg;
North-Western State Medical University named after I. I. Mechnikov, St. Petersburg
Russian Federation
Candidate of Medical Sciences, Thoracic Surgeon of Tuberculosis Pulmonary Surgical Department of the Branch of Hospital no. 1.
Russian Federation
Candidate of Medical Sciences, Thoracic Surgeon of Tuberculosis Pulmonary Surgical Department of the Branch of Hospital no. 1.
G. Yu. Marfina
St. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg
Russian Federation
Candidate of Medical Sciences, Researcher
Russian Federation
Candidate of Medical Sciences, Researcher
E. V. Karaseva
Medical Unit no. 78, Russian Penitentiary System, St. Petersburg;
North-Western State Medical University named after I. I. Mechnikov, St. Petersburg
Russian Federation
Phthisiologist of Tuberculosis Pulmonary Surgical Department of the Branch of Hospital no. 1.
Russian Federation
Phthisiologist of Tuberculosis Pulmonary Surgical Department of the Branch of Hospital no. 1.
B. D. Damadanov
Medical Unit no. 78, Russian Penitentiary System, St. Petersburg
Russian Federation
Candidate of Medical Sciences, Head of Unit
Russian Federation
Candidate of Medical Sciences, Head of Unit
V. Yu. Zhuravlev
St. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg
Russian Federation
Candidate of Medical Sciences, Researcher, Head of Laboratory Diagnostics Department
Russian Federation
Candidate of Medical Sciences, Researcher, Head of Laboratory Diagnostics Department
References
1. Belyakova N.V., Frolova O.P., Zolotareva L.V., Novoselova O.А. Analysis of tuberculosis incidence among HIV patients (using five areas of the Central Federal District as an example). Epidemiologiya i Vaktsionoprofilaktika, 2010, no. 5, pp. 54-59. (In Russ.)
2. Vladimirov K.B., Marfina G.Yu., Ivanov А.K. The role of fluorography in tuberculosis detection in HIV patients in prisons. VICH-Infektsiya i Immunosuprssiya, 2015, vol. 7, no. 2, pp. 69-76. (In Russ.)
3. Zimina V.N., Batyrov F.А., Zyuzya Yu.R., Kravchenko А.V., Toschevikov M.V., Reshetnikov M.N., Vasilyeva I.А. Tuberculosis of multiple localizations in HIV patients: specific course of the disease and diagnostics. Vestnik Ros. Gos. Med. Universiteta, 2012, no. 2, pp. 45-50. (In Russ.)
4. Kornilova Z.Kh., Lukonina I.V., Аlekseeva L.P. Tuberculosis with concurrent HIV infection. Tuberculosis and Lung Diseases, 2010, no. 3, pp. 3-9. (In Russ.)
5. Kosmak А.V., Kopylova I.F. Tuberculosis in a somatic hospital of the penitentiary system. Probl. Tub., 2008, no. 9, pp. 13-16. (In Russ.)
6. Пантелеев А.М. Clinical understanding of pathogenesis of tuberculosis generalization in HIV patients. Tuberculosis and Lung Diseases, 2015, no. 2, pp. 26-31. (In Russ.)
7. Panteleev A.M. Respiratory tuberculosis in HIV-patients. VICH-Infektsiya i Immunosuprssiya, 2010, no. 1, pp. 16-22. (In Russ.)
8. Edict no. 640/190 On Procedure for Medical Care Provision for Those Staying in the Penitentiary System and Closed Institutions. Approved by the RF Ministry of Health and Social Development and Ministry of Justice as of October 17, 2005. Moscow, 2005. (In Russ.)
9. Edict no. 951 On Approval of Guidelines for Improvement of Respiratory Tuberculosis Diagnostics and Treatment. Approved by the RF Ministry of Health as of December 29, 2014. Moscow, 2014. (In Russ.)
10. Serova V.V., Shakhgildyan V.I., Isaenko S.А., Gruzdev B.M. Ultrasound signs of spleen lesions in HIV patients. Epidemiologiya i Infektsionnye Bolezni, 2004, no. 4, pp. 35-38. (In Russ.)
11. Skornyakov S.N., Shulgina M.V., Аriel B.M., Balasanyants G.S., Vakhrusheva D.V., Vladimirov А.V., Galkin B.V., Grinberg L.M., Zhuravlev V. Yu., Kravchenko M.А., Krasnoborova S.Yu., Mordyk А.V., Petrenko T.I. Clinical recommendations of etiological diagnostics of tuberculosis. Meditsinsky Alyans, 2014, no. 3, pp. 39-58. (In Russ.)
12. Solovieva N.S., Otten T.F., Zhuravlev V.Yu., Gaschenko N.N., Shulgina M.V. Bacteriological and molecular-genetic verification of bactereimia in HIV patients. Klinicheskaya Mikrobiologiya i Antimikrobnaya Khimioterapiya, 2014, vol. 16, no. 3, pp. 248-253. (In Russ.)
13. Priority research questions for tuberculosis/human immunodeficiency virus (TB/HIV) in HIV-prevalent and resource-limited settings. WHO/HTM/TB/2010.8. WHO/HTM/HIV/2010.10.
14. Singer M., Deutschman C.S., Seymour C., Shankar-Hari M., Annane D., Bauer M., Bellomo R., Bernard G.R., Chiche J.D., Coopersmith C.M., Hotchkiss R.S., Levy M.M., Marshall J.C., Martin G.S., Opal S.M., Rubenfeld G.D., Poll T., Vincent J.L., Angus D.C. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 2016, vol. 315, pp. 801-810.
15. Waddell R.D., Lishimpi K., von Reyn C.F., Chintu C., Baboo K.S., Kreiswirth B., Talbot E.A., Karagas R.M. Bacteremia due to Mycobacterium tuberculosis or M. bovis, Bacille Calmette-Guerin (BCG) among HIV-positive children and adults in Zambia. AIDS, 2001, vol. 15, no. 1, pp. 55-60.
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For citations:
Vladimirov K.B., Marfina G.Yu., Karaseva E.V., Damadanov B.D., Zhuravlev V.Yu. ETIOLOGICAL VERIFICATION OF TUBERCULOSIS IN CASE OF SYSTEM INFLAMMATORY SYNDROME IN HIV PATIENTS. Tuberculosis and Lung Diseases. 2019;97(3):26-30. (In Russ.) https://doi.org/10.21292/2075-1230-2019-97-3-26-30
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