Current course of pneumocystic pneumonia in HIV-infected patients
- Authors: Ermak T.N.1, Samitova E.R.1, Tokmalaev A.K.1, Kravchenko A.V.1, Ermak TN2, Samitova ER3, Tokmalaev AK3, Kravchenko AV2
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Affiliations:
- Central Research Institute of Epidemiology, Moscow
- Russian University of Peoples' Friendship, Moscow
- Issue: Vol 83, No 11 (2011)
- Pages: 19-24
- Section: Editorial
- URL: https://ter-arkhiv.ru/0040-3660/article/view/30918
- ID: 30918
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Abstract
Material and methods. Detailed examination was performed in 111 HIV-infected patients with suggested diagnosis of PP. The following investigations were made: clinical, x-ray examinations, total count and biochemical blood tests, enzyme immunoassay, indirect immunofluorescence reaction (IIFR) for Pneumocystis jiroveci antigens in bronchoalveolar lavage fluid (BALF)or induced sputum. For diagnosis of other secondary diseases PCR was used for investigation of BALF and bronchial biopsy to detect DNA of Mycobacterium tuberculosis complex, Candida albicans, Cytomegalovirus, Toxoplasma gondii, Mycoplasma spа., Herpes simplex I, II. DNA of cytomegalovirus in blood was detected with PCR. Microscopic tests of the sputum were conducted for detection of acid-resistant mycobacteria.
Results. PP was associated with other secondary diseases in 59% patients (pulmonary tuberculosis - 16%, CMV pneumonia - 31%, combination of all the lesions - 5%).PP diagnosis was cancelled and pulmonary tuberculosis was diagnosed in 12 patients.In combination of PP with other pathology dominant were symptoms observed in PP monoinfection and only effective anti-pneumocystic treatment revealed signs of comorbid pathology. Tuberculosis patients had weaker signs of respiratory failure, symmetric bilateral interstitial or small-focal alterations were detected less frequently.
Conclusion. Current PP course characteristics in HIV infection are identified. In clinical diagnosis of PP special attention should be paid to data complex especially to increasing respiratory failure, high ESR, elevated lactate dehydrogenase, low blood pO2, fast response to ex juvantibus therapy. The most effective method of the diagnosis verification - BALF IIFR.
About the authors
Tat'yana Nikiforovna Ermak
Email: ermak@hivrussia.net
El'vira Rastyamovna Samitova
Anatoliy Karpovich Tokmalaev
Aleksey Viktorovich Kravchenko
T N Ermak
Central Research Institute of Epidemiology, MoscowCentral Research Institute of Epidemiology, Moscow
E R Samitova
Russian University of Peoples' Friendship, MoscowRussian University of Peoples' Friendship, Moscow
A K Tokmalaev
Russian University of Peoples' Friendship, MoscowRussian University of Peoples' Friendship, Moscow
A V Kravchenko
Central Research Institute of Epidemiology, MoscowCentral Research Institute of Epidemiology, Moscow
References
- Ермак Т. Н., Кравченко А. В., Ладная Н. Н., Шахгильдян В. И. Причины летальных исходов больных ВИЧ-инфекцией в России: ситуация в последние годы. Инфекц. бол., 2009; 7 (прил. 1): 65-66.
- Ермак Т. Н., Кравченко А. В., Шахгильдян В. И. и др. Анализ причин летальных исходов больных ВИЧ-инфекцией в РФ. Эпидемиол. и инфекц. бол. 2010; 3: 19-22.
- Самитова Э. Р. Пневмоцистная пневмония у больных ВИЧ-инфекцией: особенности клиники, диагностики и лечения: Аатореф. дис. ... канд. мед. наук. М., 2011.
- Ермак Т. Н., Перегудова А. Б., Груздев Б. М. Оппортунистические инфекции у ВИЧ-инфицированных: чудес не бывает. Тер. арх. 2006; 11: 80-82.
- Леонова Т. Е. Оценка и прогностическая значимость нарушения функции внешнего дыхания у больных ВИЧ-инфекцией: Автореф. дис. ... канд. мед. наук. М.; 2008.