COMPLETE BLOOD COUNT IN THE DIFFERENTIAL DIAGNOSIS OF PULMONARY TUBERCULOSIS AND PNEUMONIA IN PATIENTS WITH HIV INFECTION

Abstract. Introduction. Nowadays, methods for detecting Mycobacterium tuberculosis are being improved, but at the same time, general clinical methods of laboratory diagnostics, which include a complete blood count, included in the diagnostic minimum of tuberculosis screening, do not lose their significance. Aim. The aim of the study is to evaluate the value of a complete blood count in the differential diagnosis of pulmonary tuberculosis and pneumonia in patients with HIV infection. Material and methods. The parameters of the complete blood count were studied in 159 patients in the pulmonology department who were at the stage of differential diagnosis with tuberculosis. For analysis, indicators of erythrocyte sedimentation rate, leukocytes, lymphocytes and hemoglobin were selected. According to the diagnostic results, the diagnoses of pulmonary tuberculosis (n=119) and pneumonia (n=40) were verified. Statistical processing was carried out using the statistical software package IBM SPSS Statistics 22.0. Results and discussion. In a comparative analysis of the complete blood count parameters of a group of patients with a confirmed diagnosis of tuberculosis and pneumonia, statistically significant differences were found in the average hemoglobin level (by 13.25 g/l more in tuberculosis, p<0.001) and the average level of leukocytes (by 4.44*109/l less with tuberculosis, p<0.001). When studying the dependence of changes in the main indicators of a clinical blood test in HIV-infected patients on the level of CD4+ T-lymphocytes, a direct correlation (r=0.451) between the number of CD4+ T-lymphocytes and the level of hemoglobin (p<0.001) was established, the lower the number of CD4+ T-lymphocytes the lower the hemoglobin level. Conclusion. A complete blood count does not differentiate between pneumonia and tuberculosis in patients with HIV infection, but can be used in the algorithm for forming a risk group for tuberculosis in a pulmonology department. Being the most important laboratory test, it can evaluate the changes characteristic of inflammatory (infectious) lung diseases.