PULMONARY DISEASES IN HIV–INFECTED INDIVIDUALS IN HIGH HIV AND TUBERCULOSIS PREVALENCE SETTINGS: THE STRUCTURE AND FEATURES OF CLINICAL AND RADIOLOGIC MANIFESTATIONS

The aim of the study: to examine the structure, clinical and radiologic manifestations of pulmonary diseases in hospitalized HIV-infected adults in high HIV and tuberculosis prevalence settings. Materials and methods. A retrospective longitudinal study of all pulmonary diseases in HIV infected individuals (n = 185) admitted to the Internal Medicine Department of Novokuznetsk City Hospital #2 in 2017–2018. Results. The median CD4 cell count was 155 cells/μl. The most frequent diseases were community acquired pneumonia (38.4%), tuberculosis (27.0%), and septic pneumonia (16.8%). Their frequency was not associated with severity of immunodeficiency. Pneumocystis pneumonia was detected in 7.6%, other opportunistic infections (cytomegalovirus pneumonia and lymphoma) were diagnosed in 1.6% and 0.5% of cases respectively. Chronic obstructive pulmonary disease was diagnosed in 10.3% of cases. Two or more pulmonary conditions were established in 11.4% of cases. Hospital mortality accounted for 8.1% and was associated with severe immunodeficiency (CD4 < 50 cells/μl). Conclusion. Determination of the major clinical and radiological patterns typical for different pulmonary diseases enabled to establish the pillar signs for differential diagnosis and treatment tactics in HIV-infected individuals with lung pathology.