FREQUENCY OF COMPLICATIONS AND LESIONS OF ORGANS/SYSTEMS IN PULMONARY TUBERCULOSIS AMONG HIV-PATIENTS

Abstract

Objective: To study the frequency of complications and organ/system involvement in pulmonary tuberculosis in the context of HIV/AIDS infection.

Materials and Methods. We analyzed medical data from 103 patients with pulmonary tuberculosis that developed in the setting of HIV/AIDS infection. The patients were divided into groups: drug-sensitive pulmonary tuberculosis (DS-PTB) – 42 patients who excreted Mycobacterium tuberculosis (MBT) strains sensitive to anti-mycobacterial drugs (AMD); and drug-resistant pulmonary tuberculosis (DR-PTB) – 61 patients with resistant MBT strains. Data from the period 2020–2024 were analyzed.

To study the frequency of complications and organ/system involvement, the results of laboratory tests, abdominal ultrasound, computed tomography of the chest and abdominal organs, and consultations with specialized physicians were taken into account.

Microbiological detection of MBT included molecular genetic testing, microscopy and culture methods, and drug susceptibility testing of MBT strains to anti-mycobacterial drugs. HIV/AIDS infection was diagnosed using rapid tests, and viral load was determined by polymerase chain reaction. Microsoft Excel software was used for statistical analysis of the results.

Results and Discussion. In both study groups, men predominated by 1.5 times, aged over 30 to 50 years. A severe condition at admission was noted in 23.8% of patients with DS-PTB and 9.8% with DR-PTB. The average hospital stay for DS-PTB was (23.1 ± 2.1) bed-days, and for DR-PTB – (61.7 ± 4.5).

In DR-PTB/HIV, miliary tuberculosis predominated 1.7 times more often, and infiltrative pulmonary tuberculosis – 2.0 times more often. In DS-PTB/HIV, an increased frequency of disseminated pulmonary tuberculosis was observed. Patients with DR-PTB reported pronounced intoxication and cachexia twice as often compared to those with DS-PTB.

In both groups, sepsis, pericarditis, and spontaneous pneumothorax were diagnosed with nearly equal frequency. Respiratory failure was detected 1.5 times more often in DR-PTB, while chronic obstructive bronchitis was 1.7 times more frequent in DS-PTB. In both groups, chronic hepatitis, liver cirrhosis, ascites, and toxic liver damage were noted. In DR-PTB, chronic hepatitis B, nervous system involvement, and eye disorders were observed twice as often as in DS-PTB.

Conclusions. Drug-resistant pulmonary tuberculosis in the context of HIV/AIDS infection had a significantly more severe course due to the development of multiple organ failure. These changes in the combined TB/HIV/AIDS condition contributed to disability in 24.4% (10) of patients with drug-sensitive TB/HIV and in 55.7% (34) of patients with drug-resistant TB/HIV.