Open AccessSurgical treatment of patients with HIV-associated respiratory tuberculosis and different immune status
Author(s) -
С. Н. Шугаева,
A. E. Suzdalnitskiy,
Е. Д. Савилов
Publication year - 2021
Publication title -
tuberkulez i bolezni lëgkih/tuberkulëz i bolezni lëgkih
Language(s) - English
Resource type - Journals
eISSN - 2542-1506
pISSN - 2075-1230
DOI - 10.21292/2075-1230-2021-99-10-40-45
Subject(s) - medicine , tuberculosis , human immunodeficiency virus (hiv) , surgery , incidence (geometry) , lymphocyte , immune system , respiratory system , cardiothoracic surgery , immunology , pathology , physics , optics
The objective of the study: to evaluate the impact of HIV infection on the nature and results of surgical interventions in respiratory tuberculosis (RTB) patients with the relevance of their immune status. Subjects and Methods. An ambispective observational study with continuous sampling included 565 patients above 18 years old who underwent surgical interventions. The study participants were divided into RTB+HIV Group (90 patients) with HIV-associated respiratory tuberculosis and RTB Group which included 475 HIV negative patients with respiratory tuberculosis. In RTB+HIV Group, patients were divided into three subgroups: with CD4-lymphocyte count below 200 cl/μL ( n = 41), 200-499 cl/μL ( n = 26), and 500 or more cl/μL ( n = 23). Results. Compared to RTB Group, RTB+HIV Group was found to have less frequent resection surgery (24%; p 0.05) and much more frequent thoracic diagnostic surgery (11%; p < 0.0001; OR = 10.6) and extrathoracic surgery (50%; p < 0.0001; OR = 6.8). In RTB+HIV Group, patients with CD4-lymphocyte count below 200 cells/μL (46%; p < 0.05) who had no resection surgery predominated, and the rate of collapsed surgery was 2.4% ( p < 0.0001). There were no statistically signicant dierences in the incidence of postoperative complications for each individual type of surgery when stratifying participants by CD4-lymphocyte count in the intergroup comparison, as well as in RTB+HIV Group.