The nosological structure of respiratory diseases in the pulmonology in-patient unit specifying the proportion of HIV positive patients

The objective of the study: to identify respiratory diseases specifying the proportion of HIV-positive patients who have to be admitted to the pulmonology department of an emergency hospital.

Subjects and methods. All cases admitted to the pulmonology department of Emergency Relief Hospital no. 2, Omsk, from 2016 to 2019 were analyzed.

Results. Among patients admitted to the pulmonology department of the emergency hospital in 2016-2019, pneumonia was the most frequent nosology – from 51.6% (2017) to 63.2% (2019) followed by chronic obstructive lung disease – from 29.1% (2016) to 18.1% (2019). The average duration of hospital stay for pneumonia increased from 9.2 (2016) to 15.4 days (2019) that could be indicative of more severe cases due to the increased proportion of HIV positive patients from 22.4% (2016) to 49.1% (2019). Of pneumonia with the detected pathogen, cases of bacterial pneumonia were the most frequent, but in 2019 there was a significant (up to 19.3%) increase in pneumocystosis pneumonia. The frequency of lung cancer diagnostics ranged from 1.2% (2018) to 2.1% (2017 and 2019), which was associated with the low quality of early diagnosis and admission to hospital due to development of complications. The frequency of pulmonary tuberculosis detection in the pulmonology department tends to decrease every year – from 5.3% (2016) to 3.3% (2019), while the average duration of hospital stay before tuberculosis is diagnosed ranges from 4.9 ( 2016) to 5.9 days (2018). Among diagnosed tuberculosis patients, the proportion of HIV-positive people grows up every year – from 31.6% (2016) to 87.2% (2019).

1. Anopko V.P. Comprehensive medical and economic assessment of activities of a multidisciplinary hospital. Аstrakhanskiy Meditsinskiy Journal, 2010, vol. 5, no. 4, pp. 123-124. (In Russ.)

2. Borodulina E.А., Borodulin B.E., Povalyaeva L.V., Chernogaeva G.Yu., Vdoushkina E.S. Predictors of lethality due to community-acquired pneumonia in modern conditions of a pulmonary center. Vestnik Sovremennoy Klinicheskoy Meditsiny, 2015, no. 4, pp. 19-22. (In Russ.)

3. Kaminskiy G.D., Kudlay D.А., Panova А.E., Parolina L.E., Peregudova А.B., Pshenichnaya N.Yu., Samoylova А.G., Testov V.V., Tinkova V.V. Taktika vracha pri vyyavlenii, diagnostike i profilaktike sochetannoy infektsii VICH i tuberkulez: prakticheskoe rukovodstvo. [Tactics of the physician in the detection, diagnosis and prevention of TB/HIV coinfection. Practical guide]. I.A. Vasilyeva, eds., Moscow, 2020, 152 p.

4. Mamaev А.N., Kudlay D.А. Statisticheskiye metody v meditsine. [Statistical methods in medicine]. Moscow, Prakticheskaya Meditsina Publ., 2021, 136 p. ISBN 978-5-98811-635-6.

5. Metod approksimatsii v Microsoft Excel. [The approximation method in Microsoft Excel]. (Epub.), Available: https://lumpics.ru/approximation-in-excel/ (Accessed 10.11.19).

6. Murtazin A.I. Pulmonologiya. Standarty meditsinskoy pomoschi. Kriterii otsenki kachestva. Farmakologicheskiy spravochnik. [Pulmonology. Medical standards. Quality assessment criteria. Formulary]. Moscow, GEOTAR-Media Publ., 2019, 352 p.

7. Nikolenko V.V., Vorobieva N.N., Nikolenko А.V., Okishev M.А. Clinical features of the course of community-acquired pneumonia caused by Streptococcus pneumoniae and Staphylococcus aureus in HIV infected patients. Permskiy Meditsinskiy Journal, 2016, vol. 33, no. 5, pp. 9-14. (In Russ.)

8. O sostoyanii sanitarno-epidemiologicheskogo blagopoluchiya naseleniya v Rossiyskoy Federatsii v 2018 g. Gosudarstvenny doklad. [State report on the state on sanitary and epidemiological welfare of population in the Russian Federation in 2018]. Moscow, Federal Surveillance Service for Protection of Consumers' Rights and Well-Being Publ., 2019. 254 p.

9. Povalyaeva L.V., Borodulin B.E., Borodulina E.А., Chernogaeva G.Yu., Chumanova E.S. Risk factors of death in patients with community-acquired pneumonia in modern conditions. Kazanskiy Meditsinskiy Journal, 2012, vol. 93, no. 5, pp. 816-820. (In Russ.)

10. Puzyreva L.V., Paneva M.А. Community-acquired pneumonia in HIV positive patients. Byulleten Meditsinskoy Nauki, 2019, vol. 13, no. 1, pp. 69-72. (In Russ.)

11. Puzyreva L.V., Rodkina L.А., Mordyk А.V., Konchenko V.D., Dalabaeva L.M. Analysis of lower respiratory tract infections with the testing of the microbial population in specimens in HIV infected patients. Journal Mikrobiologii, Epidemiologii i Immunologii, 2018, no. 1, pp. 76-85. (In Russ.)

12. Pyanzova T.V., Labutina А.V., Аstudina O.I., Khristenko O.Yu. Clinical and diagnostic aspects of pneumocystic pneumonia in the HIV infected patients Tuberculosis and Lung Diseases, 2019, vol. 97, no. 1, pp. 63-64. (In Russ.) https://doi.org/10.21292/2075-1230-2019-97-1-63-64.

13. Chou S.H., Prabhu S.J., Crothers K., Stern E.J., Godwin J.D., Pipavath S.N. Thoracic diseases associated with HIV infection in the era of antiretroviral therapy: clinical and imaging findings. Radiographics, 2014, vol. 34, no. 4. pp. 895-911. doi: 10.1148/rg.344130115.

14. Figueiredo-Mello C., Naucler P., Negra M.D., Levin A.S. Prospective etiological investigation of community-acquired pulmonary infections in hospitalized people living with HIV. Medicine (Baltimore), 2017, vol. 96, no. 4, pp. e5778. doi:10.1097/MD.0000000000005778.

15. O'Connor J., Vjecha M.J., Phillips A.N., Angus B., Cooper D., Grinsztejn B., Lopardo G., Das S., Wood R., Wilkin A., Klinker H., Kantipong P., Klingman K.L., Jilich D., Herieka E., Denning E., Abubakar I., Gordin F., Lundgren J.D.; INSIGHT START study group. Effect of immediate initiation of antiretroviral therapy on risk of severe bacterial infections in HIV-positive people with CD4 cell counts of more than 500 cells per μL: secondary outcome results from a randomised controlled trial. Lancet HIV, 2017, vol. 4, no. 3, pp. 105-112.