Features of the Clinical Status and Comorbid Conditions in MDR-TB/HIV Patients Depending on the Level of Immunosuppression
Year: 2025
Type: article
Study design: Observational Study
Abstract: Objective — to study the features of the clinical status and accompanying pathology in patients with multidrug-resistant tuberculosis (MDR-TB)/HIV co-infection depending on the level of immunosuppression. Materials and methods. A total of 104 patients aged 20 to 55 years participated in the study, the average age was (37.2 ± 7.8) years. All patients were HIV-positive with a laboratory-confirmed case of MDR-TB. All patients were divided into 2 groups, depending on the CD4+ lymphocyte count, as follows: 1st group (TG-1) — 52 patients with MDR-TB/HIV and a CD4+ lymphocyte count of < 50 cells/μl; 2nd group (TG-2) — 52 patients with MDR-TB/HIV and a CD4+ lymphocyte count ranging from 50 to 200 cells/μl. Results and discussion. Symptoms of intoxication in the studied patients occurred more often than signs of respiratory origin. Thus, fever was registered in 94.2 % of patients of the 1st group (49 cases), and in 78.8 % (41 patients) of the 2nd group, weight loss in 40 patients (76.9 %) of TG-1 and 29 patients (55.8 %) TG-2. Pronounced weakness was present in 100 % of cases in the 1st treatment group, and in the 2nd group — only in 86.5 % of patients. Shortness of breath prevailed among respiratory symptoms, which was registered more often in TG-1 patients (29 people — 55.8 %) than in TG-2 patients (17 people — 32.7 %). Cough was registered in 29 TG-1 (55.8 %) and 22 (42.3 %) TG 2 patients. Chest pain bothered 7 (13.5 %) and 5 (9.6 %) patients with TG-1 and TG-2.Numerous complaints from other organ systems were presented as follows: loss of appetite in 86.5 % of TG-1 (45 cases) and 71.2 % of TG-2 (37 patients), difficulty swallowing and discomfort when food passes through the esophagus in 38.5 % of patients with TG -1 and 26.9 % of TG -2, diarrhea in 63.5 % of TG-1 and 36.5 % of TG-2, bloating — 25 % of TG-1 and 17.3 % of TG-2; pain in the right hypochondrium in 67.3 % of TG-1 and 46.2 % of TG-2; edema 57.7 % TG-1 and 28.8 % TG-2; insomnia — 36.5 and 21.2 % of the 1st and 2nd groups, respectively. Conclusions. Patients with MDR-TB/HIV are diagnosed with many forms of concomitant pathology in the form of: respiratory and heart failure, oropharyngeal candidiasis, chronic gastritis, duodenal ulcer disease, viral hepatitis C, B and hepatitis of intoxication genesis, phenomena of cirrhosis, hypothyroidism, chronic renal failure on against the background of kidney pathology, diseases of the genital organs (prostatitis, cervical dysplasia), encephalopathy with polyneuropathy phenomena, viral-bacterial uveitis, lesions of the skin and musculoskeletal system, etc. All this indicates the presence of multiorgan pathology, which is more pronounced in patients in a state of deep immunosuppression, with a CD4+ lymphocyte count of ≤ 50 cells/μl.
DOI: 10.30978/tb2025-2-25
Institution: Odessa National Medical University
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4410874428