Медицинский совет (Dec 2016)
CRITERIA OF MODERN TUBERCULOSIS DIAGNOSTICS IN HIV-INFECTION PATIENTS
Abstract
Approaches traditionally used in phthisiological practice to determine tuberculosis can’t be used for population of HIV-infection patients due to peculiarities of the course and forms of tuberculosis developing in conditions of immunological suppression. We analyzed 1 057 cases of the first diagnosed tuberculosis in HIV-infection patients by the nature of the disease diagnostics, forms of the tuberculosis process depending on the initial level of the immune status. In the overwhelming majority of cases (81.7%) tuberculosis was diagnosed when the patient sought medical aid. It was established than 71.7% of patients underwent the chest X-ray in less than a year before tuberculosis diagnosis and a half of them – in less than 6 month, which allows speaking about the low informative value of the chest X-ray for HIV patients even with the interval two times per year. It was established that the most frequent form of early tuberculosis diagnostics is tuberculosis of intrathoracic lymphatic nodes that should be considered as a criteria of timeliness of tuberculosis identification in HIV persons.
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