COMORBIDITY OF PULMONARY TUBERCULOSIS AND BACTERIAL PNEUMONIA IN PATIENTS WITH LATE STAGES OF HIV-INFECTION WITH IMMUNODEFICIENCY

Purpose. To study specifics of diagnostics and clinics of comorbidity of pulmonary tuberculosis and bacterial pneumonia in patients with HIV-infection with immunodeficiency. Materials and methods. Ninety-three first-time diagnosed patients with pulmonary tuberculosis and 4B stage of HIV-infection in the advanced phase in the absence of antiretroviral therapy were examined. The patients were divided into 3 groups. The 1st group included 31 patient with pulmonary tuberculosis and pneumonia associated with Streptococcus pneumoniae, the 2nd group included 31 patient with pulmonary tuberculosis and pneumonia associated with Staphylococcus aureus. The 3rd group included 31 patient without bacterial pneumonia selected by a copy-pair principle. Statistical treatment of the data was performed using Microsoft Office Excel 2019 with calculation of the mean parameter in the group and the standard error of the mean confidence interval (CI). Results. Comorbidity of pulmonary tuberculosis and pneumonia associated with S. pneumoniae or S. aureus in patients with 4B stage of HIV-infection with immunodeficiency in the advance phase with absence of antiretroviral treatment is characterized with generalization of tuberculosis and development of opportunistic infections of the lungs with severe clinical picture, high level of drug resistance of M. tuberculosis and the agents of bacterial pneumonia. At computed tomography of the chest a focal dissemination is revealed in the lungs as well as an intrathoracic lymphadenopathy and changes of the lung pattern, which almost does not differ in patients with bacterial pneumonia. Conclusion. Clinical signs and X-ray changes in combination of pulmonary tuberculosis and pneumonia associated with S. pneumoniae or S. aureus and pulmonary tuberculosis with bacterial pneumonia at the late stages of HIV-infection with immunodeficiency have the same type of character that can be diagnosed only with special microbiological viral and molecular genetic studies of abnormal material from the respiratory system and other organs with obligatory determination of drug resistance to the antituberculosis drug products and the antibacterial agents of wide spectrum. Key words: comorbidity, tuberculosis of the respiratory system, bacterial pneumonia, HIV-infection, immunodeficiency, opportunistic infections of the lungs, drug resistance.