Long-Term Outcomes of Extrapleural Thoracoplasty in HIV-Positive Patients with Destructive Pulmonary Tuberculosis

The objective: to evaluate long-term outcomes of extrapleural thoracoplasty (ET) in HIV-positive patients with destructive pulmonary tuberculosis (TB) and to identify socio-medical factors influencing these outcomes.

Materials and methods. The outcomes of 55 HIV-positive patients with destructive pulmonary tuberculosis were evaluated across two follow-up periods: from 6 months to 2 years, and from 2 to 5 years after the discharge from the surgical department. When evaluating the ET results, the following outcomes were reported: cured of TB, discharged from dispensary follow-up, transferred to dispensary follow-up group III, and continuing treatment (including TB relapses after ET). Concurrently, the course of HIV-infection was evaluated based on the viral load and CD4+ T-lymphocyte levels. Cases of loss to follow-up for TB chemotherapy and ART, TB relapses, HIV progression and fatalities (due to HIV infection, TB, or other causes) were recorded.

Results. Among 55 patients with destructive pulmonary TB and HIV infection, the 5-year post-operative follow-up outcomes after extrapleural thoracoplasty were as follows: 29 (52.7%) patients were cured of TB and discharged from the follow-up group; 3 (5.5%) remained in the follow-up group III; 4 (7.3%) continued TB treatment (all of whom had pre-XDR and a history of treatment interruption); 2 (3.6%) were lost to follow-up. Fatal outcomes due to various causes were reported in 17 (30,9%) patients.

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