Clinical and epidemiological characteristics of secondary diseases in HIV-infected patients in hospital care

Abstract

The aim of the study was a comparative catamnestic and clinical - epidemiological analysis of secondary diseases in HIV infected patients undergoing inpatient treatment.

Material and methods. The analysis of 60 case histories of patients diagnosed with HIV infection who were admitted in 2011 and 2017 to the boxed Department of the Republican Clinical Infectious Diseases Hospital named after professor A.F. Agafonov (Kazan).

Results and discussion. In 2011, 40 patients were hospitalized; in 2017, 20 were treated. The use of psychoactive substances (surfactants) in the anamnesis in 2011 was indicated by 70% of patients, and 32.5% of patients received antiretroviral therapy (ART). In the structure of infectious diseases in 2011, 42.5% were diagnosed with bronchopulmonary diseases: 47% - community-acquired pneumonia (of which 75% of patients received ART), 53% - pulmonary tuberculosis (89% on ART); chemoprophylaxis of tuberculosis was performed in 5% of patients. Herpetic infection of various localization was detected in 12% of cases. Sepsis was registered only in 2011 [in 15% of patients who in most cases (87%) consumed heroin].

In 2017, the number of users of surfactants was less than 45% of patients, and only 20% of patients received ART. The incidence of bronchopulmonary pathology decreased (25%), but the number of cases of pulmonary tuberculosis increased to 60% (all patients without ART). More often began to carry out chemoprophylaxis of tuberculosis (in 30% of patients), to register a herpetic infection (80%). Liver diseases: at the time of hospitalization in 2011 and 2017, a total of 55% of patients were diagnosed, including cirrhosis of the liver in 21% of cases. Cirrhosis of the liver was formed on average 8.14±0.5 years after the diagnosis of chronic hepatitis.

No deaths were recorded during inpatient treatment, but by 2020, the mortality rate among inpatient patients in 2011 was 40%; among those hospitalized in 2017, it was 10%. Early administration of ART to all patients, high patient adherence, and chemoprophylaxis of tuberculosis when the number of CD4+-lymphocytes is less than 350 cells/MCL are predictors of control over the course of HIV infection, which should lead to a reduction in hospital admissions in the coming years.

Keywords:HIV infection, hospitalization, secondary diseases, comorbidities, lethality

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

Contributions. Idea and concept solution - Fazylov V.Kh., Manapova E.R.; design - Manapova E.R., Akifev V.O.; collection and statistical processing of materials - Akifev V.O.; text decoration - Manapova E.R., Akifev V.O.; editing - Fazylov V.Kh., Manapova E.R.

For citation: Fazylov V.Kh., Manapova E.R., Akifev V.O. Clinical and epidemiological characteristics of secondary diseases in HIV-infected patients in hospital care. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2020; 9 (4): 81-7. DOI: https://doi.org/10.33029/2305-3496-2020-9-4-81-87 (in Russian)

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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