CLINICAL MANIFESTATIONS AND DIAGNOSIS OF CO-INFECTION OF COVID-19, TUBERCULOSIS AND OPPORTUNISTIC PULMONARY INFECTIONS IN LATE-STAGE HIV PATIENTS

Abstract Objective The purpose of the study was to investigate the specific features of clinical manifestations and diagnosis of co-infection of COVID-19, tuberculosis and opportunistic pulmonary infections in late-stage HIV patients. Design 27 patients with co-infection of COVID-19, tuberculosis, opportunistic pulmonary infections and late-stage HIV infection with immunodeficiency without antiretroviral therapy (group 1) and 27 patients with equivalent parameters but without COVID-19 (group 2) were examined. Results The patients of the group 1 and group 2 are the persons with social maladjustment and substance addiction. All of them have concomitant viral hepatitis B/C, COPD, opportunistic pulmonary infections and similar clinical and radiological manifestations, which can only be differentiated with microbiological and molecular genetic studies. The patients with co-infection of COVID-19, tuberculosis and HIV pose a high risk of transmission of infection to healthy persons in view of non-adherence to examination and treatment. Conclusion To prevent the spread of infection among the healthy population, it is necessary to arrange in a mandatory manner an active and regular COVID-19 testing of all patients with tuberculosis/HIV co-infection, especially of late-stage HIV patients without antiretroviral therapy, in the tuberculosis care unit for HIV-infected persons at the tuberculosis dispensary. Setting There are few data on the specific features of clinical manifestations of co-infection of COVID-19, tuberculosis (TB) and opportunistic pulmonary infections (OPI) in late-stage HIV patients with immunodeficiency. Objective Study purpose is to investigate the specific features of clinical manifestations and diagnosis of co-infection of COVID-19, TB and OPI in late-stage HIV patients with immunodeficiency. Design Fifty-four (54) patients admitted for inpatient treatment at the TB Clinical Hospital N 3 named after Zakharyin were enrolled in this prospective study. The participants were assigned to two groups: group 1 (main) and group 2 (comparison group). Group 1 consisted of twenty-seven (27) aged 28-52 patients (18 men (66.7 ± 9.1%) and 9 women (33.3 ± 9.1%)) with known co-infection of COVID-19, sputum smear-positive for M. tuberculosis (MBT) pulmonary tuberculosis (PTB) and with late-stage HIV infection in progression phase without antiretroviral therapy (ART). Group 2 included 27 patients who were selected using the “copy-pair” method and were completely identical to the patients of the main group (with virtually the same age, sex, social parameters and clinical and laboratory indicators), but without diagnosis of COVID-19.