FEATURES OF PATOMORPHOSIS AND THE COURSE OF HIV-ASSOCIATED DISEASES IN THE TERMINAL HIV-INFECTION IN ADDICT PATIENTS
About the author:
Turkevich M., Pospishil Yu., Ribun B., Sydorenko I.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The aim of the study was to determine the peculiarities of pathomorphosis, course and frequency of occurrence of HIV-associated diseases in HIV-positive persons having 3-rd and 4-th clinical stages of the disease with and without drug addiction for the period 2016-2018in Lviv region. Object and methods of research. A retrospective study of 188 cases of deaths in the hospitals of Lviv region of HIV-infected persons for the period from 2016 to 2018 was conducted. The pathological study was underwent at the Lviv Regional Pathology Department. All cases were divided into 2 groups (totally n=188): HIV-infected persons with drug addiction (DA); and HIV-positive individuals without a reference to drug addiction (NDA).Protocols of section and micropreparations stained with hematoxylin-eosin routine technique were used for the study. The membership of the deceased in one of the study groups was established according to the records in the medical records of inpatients and the protocols of pathologic examination, as well as according to macroscopic examination of the body, namely, the external examination of the deceased (absence or presence of so-called “injection mines”). Results and discussion. It was found that manifestations of mycobacterial infection (including tuberculosis, in particular, HIV/TB co-infection) were observed in 78% of the DA, which was mostly generalized with lesions of brain, all groups of lymph nodes, kidney, spleen, intestine (52%), or isolated only lungs (26%). Among patients from the NDA group generalization of the process was determined only in 48.5% (p≤0.01), and pulmonary tuberculosis – 10.1%. The combination of mycobacterial lesions with candidomycosis was found in every 2 DA patient (44%), whereas in the NDA group the number of deaths with this combination of nosologies was 31.8% (p≤0.06). A low percentage of patients receiving treatment in the 18-25 age group and over 46 years of age is associated with the late treatment and diagnosis of late-stage HIV and short-term hospitalization. The course of HIV/AIDS in DA patients was characterized by greater severity – generalized or severe isolated forms of mycobacterial (78%) and candidiasis (82%) lesions of organs and systems. Higher in this group was also the rate of development of meningoencephalitis caused by toxoplasma (20%), cytomegalovirus (10%). The frequency of skin lesions in patients with HIV infection was 5%, the structure of lesions was dominated by: seborrheic dermatitis, hairy leukoplakia of the tongue and herpetic lesions (1.1% each).
HIV infection, AIDS, injectable drug addiction, generalized mycobacterial infection, candidiasis, HIVassociated diseases.
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 212-215 pages, index UDK 616-002.5-06(616.98+616.89-008.452)]-091.8