Туберкулез и болезни лёгких (Sep 2018)

FACTORS PROVIDING IMPACT ON THE EFFICIENCY OF VALVE BRONCHIAL BLOCK IN THE COMPREHENSIVE TREATMENT OF DESTRUCTIVE PULMONARY TUBERCULOSIS WITH CONCURRENT HIV INFECTION

  • D. V. Krasnov,
  • Ya. K. Petrova,
  • S. V. Sklyuev,
  • E. P. Myshkova

DOI
https://doi.org/10.21292/2075-1230-2018-96-8-25-30
Journal volume & issue
Vol. 96, no. 8
pp. 25 – 30

Abstract

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Valve bronchial block is successfully used for the healing of cavities in tuberculosis patients, including those with HIV infection.The objective of the study: to investigate factors providing an impact on the healing of destructive changes when using valve bronchial block in the patients with TB/HIV co-infection.Subjects and methods. Valve bronchial block was used in 68 HIV positive patients as a part of the comprehensive treatment of tuberculosis. Depending on its outcome, 2 groups of patients were identified: those in whom the cavity was healed (n = 38) and those in whom the cavity persisted (n = 30). The factors providing an impact on the efficiency of valve bronchial block in those groups were investigated.Results. This method was the most effective in the patients who had tuberculous lesions in the upper lobes, with cavities up to 2 cm in diameter, scanty bacillary excretion, CD4 count above 250 cells/mcl, and good adherence to antiretroviral therapy, if it was indicated. The factors providing impact on destruction persistence during the valve bronchial block were the following: cavities from 4 to 7 cm, persisting moderate or massive bacillary excretion, extensive drug resistance, CD4 count below 250 cell/mcl, especially below 100 cells/mcl.

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