Surgical methods in the diagnostic of tuberculosis in HIV patients

<b>Introduction:</b> Tuberculosis (TB) often affects HIV patients as opportunistic disease, but diagnosis of TB among them needs not only traditional bacteriological or radiation methods because TB manifestation in HIV patients can be very specific. The differential diagnosis of various pathologies of the lung (lung lesions) in some cases is optimally realized through diagnostic minimally invasive surgical interventions, while it can ensure a minimum of complications, but can needs monitoring the immune status. <b>Methods:</b> The results of 105 diagnostic thoracic surgeries in HIV patients with an undetermined diagnosis of lung lesions and performed in Moscow research and clinical center for tuberculosis control in 2014 - 2018 were studied. Minimally invasive methods were mainly used. The obtained diagnostic material was subjected to morphological, molecular genetics and bacteriological analysis. <b>Results:</b> A diagnosis of TB was established by surgical interventions in 74 (70.5%) patients; a non-TB etiology of the disease was detected in 31 (29.5%). Diagnosed diseases of non-TB etiology included: with nonspecific pleurisy was 13 (12.4%), with lymphoma - 6 (5.7%), with benign neoplasms - 3 (2.9%), with Kaposi9s sarcoma - 2 (1.9% ), with mycobacteriosis - 3 (2.9%), with sarcoidosis - 2 (1.9%), with Kaposi9s sarcoma - 2 (1.9% ), with a lung cyst and aspergilloma - 1 (0.95%) for both of them.Complications in the postoperative period were noted in 2 (1.9%) patients.Median of CD4+ before interventions was 214.5 (IQR 98 – 357), and after – 253.0 (IQR 150-450) with significant growth (p &lt; 0.01, Wilcoxon Matched Pairs Test). <b>Conclusions:</b> Diagnostic surgery for lung pathology in HIV patients had been shown to be effective and safe.