MORPHOLOGICAL DIAGNOSTICS OF INFECTIOUS DISEASES AMONG HIV-INFECTED PATIENTS WITH THORACIC PATHOLOGY
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i3.11592Keywords:
HIV infection, tuberculosis, opportunistic diseases, histological examination, diagnosisAbstract
HIV infection is associated with an ever-increasing number of people with opportunistic diseases and an increasing mortality from them. The incidence of respiratory diseases is more than 60 %, while tuberculosis is most often diagnosed. Diagnostic options regarding opportunistic diseases remain limited. In addition, now more than 50 % of patients have an association of various secondary diseases, which leads to an increase in the severity of their course, problems of diagnosis and treatment.
The aim – to establish the diagnostic effectiveness of the integrated use of various histological methods to verify the etiology of infectious lesions of thorax associated with HIV infection.
Material and Methods. The study included of 31 cases of secondary infectious lesions of the thorax in HIV-infected patients. First of all, a traditional histological examination was performed. In addition, histochemical methods were used: Ziel-Nielson method, fluorescence method, Gomori-Groccott’s method and PAS-reaction with alcian blue, and immunohistochemical studies to detect mycobacterial antigens with two polyclonal antibodies to M. tuberculosis.
Results. According to the results of a comprehensive histological examination, 15 (48.4 %) cases of the tuberculosis were diagnosed. Comparison of the preliminary and final clinical diagnosis of all cases of our study showed, that only 3 cases (9.7 %) received confirmation of the preliminary clinical diagnosis, in 9 cases (29.0 %) the clinical diagnosis was clarified and in 12 cases (38.7 %) the diagnosis is established. In another 5 cases (16.1 %), the preliminary clinical diagnosis was wrong and was changed. And only in 2 (6.5 %) cases the final diagnosis was not established. Thus, in 25 cases (80.6 %) the development of a fungal infection was established and in 15 cases (48.4 %) tuberculosis was diagnosed. Overall in 16 (51.6 %) cases there were revealed associations of various secondary infections.
Conclusions. When conducting morphological diagnostics in cases of HIV-infected patients with secondary infectious lesions of the thorax, it is advisable to use a number of special histochemical methods for examining the affected tissues. In 67.7 % cases with an extended morphological study, the initial histopathological conclusion was clarified or completely changed. The overall effectiveness of a comprehensive morphological study was 93.5 %.
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