SIGNIFICANCE OF ANTHROPOMETRIC INDICATORS IN DIFFERENTIAL DIAGNOSIS OF PULMONARY PATHOLOGY IN HIV-POSITIVE PERSONS

Abstract

The aim – to study and determine the possibilities of using the anthropometric method in conducting differential diagnosis in HIV patients with lower respiratory tract lesions.

Materials and methods. A longitudinal retrospective study was conducted. The object of the study – HIV patients with lower respiratory tract lesions. The subject of the study is the differential diagnosis of pulmonary system lesions in HIV-infected patients. To achieve the goal of the study we used anthropometric method, which included measuring body weight with medical levers, patient height with a medical height meter and the thickness of the fat layer in the biceps, triceps, subscapular and umbilical region with a caliper. Measurements were performed according to the instructions for the medical device. After receiving the results of the study, statistical data processing was performed using methods of variation statistics and correlation analysis using Microsoft Office Excel 2007 for Microsoft Windows.

Research results. Differential clinical criteria for bacterial pneumonia in HIV and HIV/TB co-infection are difficult to determine, especially against the background of severe immunosuppression. During the measurement of weight and height of patients and calculation of body mass index, it was found that the body mass index (BMI) in both groups was within acceptable limits (≥18.5 and <25), but in the group of HIV co-infection / TB was significantly lower than in the group of HIV patients with bacterial pneumonia (p <0.001). The thickness of the subcutaneous fat layer in the group of patients with HIV / TB co-infection was significantly smaller compared to the first group, which indicates a difference in the pathophysiological processes underlying the development of pathology that caused lung damage on the background of immunodeficiency. The analysis performed in the studied groups with the compared indicators revealed a strong direct correlation (p <0.001). Based on the obtained data, a diagnostic anthropometric formula is proposed in order to optimize the differential diagnosis in the group of HIV patients with bacterial pneumonia and HIV/TB co-infection.

Conclusion. Our study revealed that HIV patients with bacterial pneumonia and HIV/TB co-infection have special differences in anthropometric data: the difference in body mass index and subcutaneous fat fold thickness at four specific points, the cause of which lies in immunopathogenesis. and due to more pronounced immune and metabolic changes in HIV/TB, which is due to the phenomena of chronic inflammation and was confirmed by anthropometry with subsequent correlation analysis. A diagnostic anthropometric formula is proposed, using the data of body mass index and subcutaneous fat layer thickness at four defined points, which can be used as an additional factor and criterion for differentiation of tuberculosis infection in HIV-infected persons. The obtained data can be used in the differential diagnosis of bacterial pneumonia and tuberculosis in the category of HIV patients.