Evaluation of risk factors of disease progression in HIV-infected patients with relapses of pulmonary tuberculosis
DOI:
https://doi.org/10.14739/2310-1237.2016.1.71187Keywords:
Tuberculosis, HIV, Coinfection, Risk Factors, Disease ProgressionAbstract
There are no defined risk factors for progression of TB in HIV-positive patients with relapses of pulmonary tuberculosis (RTB/HIV) nowadays. In order to identify the risk factors of disease progression 23 patients with RTB/HIV were examined; we determined complex influence of clinical, radiological, immunological and laboratory parameters on the progression of TB.
We determined the following risk factors: the presence of systemic inflammatory response syndrome, massive bacterial excretion, multiple destructive process in the lungs, reducing the number of CD4+-cells < 200 cells/mm ("large criteria"). Each "large criterion" is estimated at one point. To enable the laboratory data as predicting disease progression criteria in patients with RTB/HIV the simultaneous presence of any 3-of-9 indicators that relate to "small criteria" is necessary in patients (reduction of Hb level <110 g/l, decreased lymphocyte count <20%, decreased hematocrit <35 units., increased leukocyte intoxication index >2.0 units, decreased lymphocyte level <0.25 units, the presence of C-reactive protein in the blood, fibrin level 9> and <18 g/l, albumin level reduction <40%, reduction of albumins/globulins <0.7 units). In this case each "small criterion" we estimate at 1 point. To determine the progressive course minimum number of points (1 out of 5) is necessary.
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