RETROSPECTIVE ANALYSIS OF MORBIDITY OF COMMUNITY-ACQUIRED PNEUMONIA AMONG HIV-POSITIVE PATIENTS IN KHARKIV FOR THE PERIOD OF 2013–2017
DOI:
https://doi.org/10.11603/1681-2727.2019.1.9941Keywords:
HIV infection, bacterial pneumonia, clinic, diagnosis, preventionAbstract
The aim of the work – to conduct a retrospective and structural analysis of the infectious disease in pulmonary pathology among HIV-infected persons who were treated at the Regional Anti-tuberculosis Dispensary in Kharkiv for the period of 2013–2017; separate the number of cases of bacterial pneumonia in the background of HIV for the period of 2013–2017, determine the risk factors for its occurrence, clinical features of the course, diagnosis depending on the immune status; features of treatment you can prevent.
Materials and methods. A retrospective analysis of the incidence of HIV-infected persons in pulmonary pathology was carried out using 191 medical records of the inpatient patient, 102 of whom were selected for the treatment of HIV-infected persons with bacterial pneumonia in the hospital in the period of 2013–2017. The statistical processing of the data obtained using the methods of variation and correlation statistics with the use of software.
Results. Unresponsive bacterial pneumonia in HIV-positive individuals occurs at any level of CD4+ T-lymphocytes in 1 μl, and its frequency is progressively increased as the immunosuppression intensifies. The clinical course does not differ from those with HIV-negative status, but CD4+ T-lymphocytes lower than 50 μl in 1 μl have a more severe course and signs of invasiveness of the traditional agent, especially in association with Candida albicans and / or Pneumocystis jiroveci.
Conclusions. Over the study period from 2013–2017 the number of cases of community-acquired bacterial pneumonia on the background of HIV was increased. Factors that increase the risk of its occurrence are drug use, alcohol abuse and smoking, as well as low coverage of ART. The pathogen from sputum was isolated in 26.5 % of cases. The more severe clinical course of bacterial pneumonia was in the group of patients with a number of CD4 + T-lymphocytes <50 in 1 μl, bacteriologically in this group in the sputum besides the common causative agent Candida albicans and/or Pneumocystis jiroveci were present, which complicated the clinical picture, radiologically at this was the tendency to generalize the process in the lungs. There are no multi-prophylaxis in preventing the occurrence of community-acquired bacterial pneumonia in HIV-infected patients due to the huge number of its pathogens, therefore the risk of its occurrence in this category will always be present and always higher than in the general population, taking into account the immune deficiency. The only recommendations for prevention are the use of 23-valent polysaccharide pneumococcal vaccine and the annual vaccination of influenza.
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