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Опыт клинической диагностики ВИЧ-инфекции в условиях профильного стационара

Опыт клинической диагностики ВИЧ-инфекции в условиях профильного стационара

Abstract

Цель. На основании клинического анализа стационарных случаев ВИЧ-инфекции оценить структуру оппортунистических и сопутствующих заболеваний с учётом стадий развития инфекционного процесса. Методы. Проанализированы случаи стационарного лечения 40 пациентов с диагнозом «ВИЧ-инфекция» в возрасте от 25 до 42 лет (34,26±1,22 года), 14 женщин и 26 мужчин, со сроком инфицирования 6,7±0,6 года. Результаты. В стационар пациенты поступали в среднем на 17±3,24 день болезни, в том числе при патологии бронхолёгочной системы — на 23±3,6 день болезни, с реактивацией хронического гепатита и декомпенсацией цирроза печени — на 30±10,09 день болезни, с острыми инфекциями — на 7±1,16 день болезни. В анамнезе употребление психоактивных веществ подтверждено у 28 (70,0%) пациентов. Антиретровирусную терапию получали 13 (32,5%) больных, 3 (7,5%) самовольно её прервали, остальные никогда не получали такого лечения. По стадиям ВИЧ-инфекции (классификация Покровского В.И.) пациенты распределились следующим образом: III стадия — 4 (10,0%) человека, стадия IVА — 8 (20,0%), IVБ — 11 (27,5)%, IVВ — 17 (42,5%) больных. В структуре диагнозов преобладали бронхолёгочные заболевания — 17 (42,5%), из них 8 (47,1%) — внебольничная пневмония (очаговая, полисегментарная, интерстициальная, лобарная), 9 (52,9)% — туберкулёз лёгких (инфильтративный, милиарный, туберкулёз внутригрудных лимфатических узлов). В структуре сопутствующей патологии преобладали заболевания печени: хронический гепатит С, хронический гепатит С + В, цирроз печени — у 21 (52,5%) пациента. Вывод. На ранних стадиях ВИЧ-инфекции преобладающими сопутствующими заболеваниями являются herpes zoster и заболевания печени, тогда как на поздних стадиях на передний план выходят оппортунистические инфекции, туберкулёз, внебольничные пневмонии и септические состояния.

Aim. To assess the structure of opportunistic infections and concomitant diseases, including the stage of infection, in patients hospitalized with HIV-infection. Methods. 40 cases of in-patient treatment of patients diagnosed with HIV aged 25 to 42 (mean age 34.26±1.22), male — 26, female — 14, with mean duration of infection 6,7±0,6 years were analyzed. Results. The patients were admitted to the hospital on 17±3.24 day of the disease, including cases of pulmonary diseases (on 23±3.6 day), cases of chronic hepatitis reactivation and liver cirrhosis decompensation (on 30±10.09 day), cases of acute infections (on 7±1.16 day). Previous psychoactive drug use was confirmed in 28 (70.0%) of patients. 13 (32.5%) patients received treatment with antiretroviral drugs, 3 (7.5%) have abandoned it, the rest had never been offered an antiretroviral treatment. According to the classification by V.I. Pokrovsky, the patient were staged as: stage Ш — 4 (10.0%) patients, stage IVA — 8 (20.0%), IVB — 11 (27.5)%, IVC — 17 (42.5%) patients. Pulmonary diseases were the most prevalent and were diagnosed in 17 (42,5%) patients, including cases of community-acquired pneumonia (focal, multisegmental, interstitial, lobular) in 8 (47.1%) patients, pulmonary tuberculosis (infiltrative, military, intrathoracic lymph nodes tuberculosis) in 9 (52.9)% patients. Liver diseases (chronic hepatitis B, chronic hepatitis B + C, liver cirrhosis) were the most frequent concomitant diseases and were found in 21 (52.5%) patients. Conclusion. Herpes zoster and liver diseases are the most predominant concomitant diseases at the early stages of HIV-infection, whereas ooportunistic infections, tuberculosis, community-acquired pneumonia and sepsis are typical in patients with late stages of HIV-infection

Keywords

ВИЧ-ИНФЕКЦИЯ, ОППОРТУНИСТИЧЕСКИЕ ЗАБОЛЕВАНИЯ, АНТИРЕТРОВИРУСНАЯ ТЕРАПИЯ, РЕСПУБЛИКА ТАТАРСТАН

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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