Evaluation of risk factors of disease progression in HIV-infected patients with relapses of pulmonary tuberculosis

• Main Author: R. M. Yasinskiy
• Format: Article
• Language: English
• Published: Zaporozhye State Medical University 2016-04-01
• Series: Patologìâ
• Subjects: Tuberculosis; HIV; Coinfection; Risk Factors; Disease Progression
• Online Access: http://pat.zsmu.edu.ua/article/view/71187/68183

There are no defined risk factors for progression of TB in HIV-positive patients with relapses of pulmonary tuberculosis (RTB/HIV) nowadays. In order to identify the risk factors of disease progression 23 patients with RTB/HIV were examined; we determined complex influence of clinical, radiological, immunological and laboratory parameters on the progression of TB. We determined the following risk factors: the presence of systemic inflammatory response syndrome, massive bacterial excretion, multiple destructive process in the lungs, reducing the number of CD4+-cells < 200 cells/mm ("large criteria"). Each "large criterion" is estimated at one point. To enable the laboratory data as predicting disease progression criteria in patients with RTB/HIV the simultaneous presence of any 3-of-9 indicators that relate to "small criteria" is necessary in patients (reduction of Hb level <110 g/l, decreased lymphocyte count <20%, decreased hematocrit <35 units., increased leukocyte intoxication index >2.0 units, decreased lymphocyte level <0.25 units, the presence of C-reactive protein in the blood, fibrin level 9> and <18 g/l, albumin level reduction <40%, reduction of albumins/globulins <0.7 units). In this case each "small criterion" we estimate at 1 point. To determine the progressive course minimum number of points (1 out of 5) is necessary.