Spectrum, clinical features, diagnosis of opportunistic and comorbid pathology in HIV-infected patients admitted to infection hospital of Moscow
Shakhgil'dian, V.I.; Vasil'eva, T.E.; Peregudova, A.B.; Gruzdev, B.M.; Danilova, T.V.; Martynova, n.N.; Filippov, P.G.; Litvinova, N.G.; Pavlova, l.E.; Tishkevich, O.A.; Iuditskiĭ, M.V.; Ol'shanskiĭ, A.I.; Mazus, A.I.
Terapevticheskii Arkhiv 80(11): 10-17
2008
ISSN/ISBN: 0040-3660 PMID: 19143183 Document Number: 627625
To analyse structure, clinical features, diagnosis of opportunistic and concomitant diseases in patients with HIV infection admitted to infection hospital of Moscow. A total of 4155 patients with HIV infection (1518 of them with AIDS) most of them (89%) at the age of 20-39 years were treated in Moscow AIDS hospital in 2006-2007. The examination included standard blood and urine tests, device diagnosis, immunological, bacteriological and molecular investigations of biological materials for detection of opportunistic infections. Cell-mediated immunity was also studied. HIV infection resulted in a lethal outcome in 255 (6.1%) inpatients. Leading causes of hospitalization of patients at early stages of HIV infection were bacterial bronchitis or pneumonia, hepatic pathology (chronic viral hepatitides, alcohol-associated diseases), sepsis. One-third of the inpatients were at AIDS stage characterized by tuberculosis (66.3%), visceral candidosis (12%), manifest cytomegalovirus infection (10.1%), cerebral toxoplasmosis (9.2%), pneumocystic pneumonia (5.5%). The number of HIV-infected persons with atypical mycobacteriosis, lymphoproliferative diseases, brain tumors increased. Chronic hepatitis C prevailed among liver damage cause in HIV infection, it also often caused hospitalization and death of patients. 60.3% patients having HIV infection who died without AIDS stage had hepatic cirrhosis. Tuberculosis was a leading cause of severe pulmonary pathology, most frequent opportunistic disease, main cause of death in patients with HIV infection. One-third of patients had generalized tuberculosis. Tuberculosis was diagnosed in more than 40% HIV-infected patients with pulmonary lesion, in 65% AIDS patients, 36% dead AIDS patients. To render effective anti-HIV treatment, infection hospital must be equipped with facilities providing device tests, molecular diagnosis, modern etiotropic and pathogenetic medication.