Surgical treatment of patients with HIV-associated respiratory tuberculosis and different immune status
https://doi.org/10.21292/2075-1230-2021-99-10-40-45
Abstract
The objective of the study: to evaluate the impact of HIV infection on the nature and results of surgical interventions in respiratory tuberculosis (RTB) patients with the relevance of their immune status.
Subjects and Methods. An ambispective observational study with continuous sampling included 565 patients above 18 years old who underwent surgical interventions. The study participants were divided into RTB+HIV Group (90 patients) with HIV-associated respiratory tuberculosis and RTB Group which included 475 HIV negative patients with respiratory tuberculosis. In RTB+HIV Group, patients were divided into three subgroups: with CD4-lymphocyte count below 200 cl/μL (n = 41), 200-499 cl/μL (n = 26), and 500 or more cl/μL (n = 23).
Results. Compared to RTB Group, RTB+HIV Group was found to have less frequent resection surgery (24%; p < 0.0001; OR = 3.0) with acomparable frequency of collapsed surgery (4%; p > 0.05) and much more frequent thoracic diagnostic surgery (11%; p < 0.0001; OR = 10.6) and extrathoracic surgery (50%; p < 0.0001; OR = 6.8). In RTB+HIV Group, patients with CD4-lymphocyte count below 200 cells/μL (46%; p < 0.05) who had no resection surgery predominated, and the rate of collapsed surgery was 2.4% (p < 0.0001). There were no statistically significant differences in the incidence of postoperative complications for each individual type of surgery when stratifying participants by CD4-lymphocyte count in the intergroup comparison, as well as in RTB+HIV Group.
About the Authors
S. N. Shugaeva
Irkutsk State Medical Academy of Postgraduate Education – Branch of Russian Medical Academy of Continuing Professional Education; Irkutsk State Medical University
Russian Federation
Russian Federation
Svetlana N. Shugaeva, Doctor of Medical Sciences, Associate Professor
1, Krasnogo Vosstaniya St., Irkutsk, 664003
A. E. Suzdalnitskiy
Irkutsk State Medical University
Russian Federation
Russian Federation
Aleksey E. Suzdalnitskiy, Assistant of Phthisiopulmonology Department
1, Krasnogo Vosstaniya St., Irkutsk, 664003
E. D. Savilov
Research Center of Family Health and Reproduction Problems
Russian Federation
Russian Federation
Evgeniy D. Savilov, Research Center of Family Health and Reproduction Problems, Siberian Branch of the Russian Academy of Medical Sciences. Doctor of Medical Sciences, Professor, Honored Researcher of Russia, Chief Researcher
16, Timiryazeva St., Irkutsk, 664003
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Review
For citations:
Shugaeva S.N., Suzdalnitskiy A.E., Savilov E.D. Surgical treatment of patients with HIV-associated respiratory tuberculosis and different immune status. Tuberculosis and Lung Diseases. 2021;99(10):40-45. (In Russ.) https://doi.org/10.21292/2075-1230-2021-99-10-40-45
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