Clinical and morphological characteristics and outcomes of tuberculosis process in patients suffered from HIV infection

The purpose of research is to perform an analysis of features of the clinical course of comorbidity tuberculosis + HIV infection and proximate causes of death of patients. In the article there was performed a comparative analysis of the clinical and radiological, bacteriological and morphological data of 74 deceased patients, divided into two groups: main (cases with the presence of co-infection: tuberculosis associated with HIV infection) and a comparison group (TB mono-infected persons).The performed analysis of the clinical course, the data of microbiological examination and radiographic findings in 74 of the dead patients allowed to reveal features of the course of tuberculosis in HIV infection cases at the IV stage: acute onset of illness, debilitating fever, full-blown bronchopulmonary syndrome and intoxication, massive bacterial excretion. In co-infection patients at the advanced stages with a significant decrease in the level of CD4+ lymphocytes there was no tendency to develop of tuberculous granuloma. The evolution of the process was characterized by the acute generalized by lymphatic/hematogenous and hematogenous dissemination with combined lesions of the internal organs (meninges, lungs, liver, spleen, adrenal glands, pancreas, heart, mesenteric lymph nodes). Tuberculosis granulomatous response as a mode of specific antituberculosis protection failed to develop, the changes were mostly exudative-necrotic inflammation in character due to the presence of immunodeficient state. At the same time in patients without HIV infection the process was classic in character: there were developed isolated lung lesions without the involvement of other organs. Morphological changes were presented by formed tuberculous granulomas with epithelioid cell infiltration and pronounced caseous necrosis. The cause of death in the study group patients was generalized tuberculosis with simultaneous defeat of several vital organs.

tuberculosis, HIV infection, sick