GENDER-RELATED FEATURES OF CLINICAL TB IN HIV-POSITIVE PATIENTS

bjective: to compare sociodemographic characteristics, clinical, radiological and laboratory manifestations of TB in males and females with TB/HIV co-infection. Materials and methods. The study enrolled 295 patients, who were divided into two groups. The main group included 152 pulmonary TB patients with HIV co-infection (Group TB/HIV), the comparison group included 143 pulmonary TB patients without HIV co-infection (Group TB). Group TB/HIV included 110 males and 42 females. Group TB included 96 males and 47 females. All patients underwent a comprehensive study in hospital. Demographic and social indicators, results of clinical, radiological and laboratory examinations were analyzed separately for male and female patients. Results. The analysis of demographic indicators established that most males with TB/HIV comorbidity were over 40 years of age, while most females were under 40 years of age. The frequency of tobacco smoking, alcohol abuse, parenteral transmission of HIV, and incarceration was significantly higher among males. Chronic hepatitis C virus co-infection was also more typical for males. The analysis of TB process in TB/HIV patients revealed that disseminated and generalized TB, cavities up to 2 cm, scanty bacterioexcretion, multidrug resistance, dyspnea, and pronounced inflammatory intoxication were more typical for males. Females fell ill with TB in a younger age (under 40 years old). Disseminated and infiltrative TB, tuberculomas and cavities more than 2 cm in diameter, moderate bacterioexcretion and drug susceptibility were more typical for females. Most males were at stage 4, females – 3 HIV infection; typically, in males TB was diagnosed before HIV infection, while in females TB and HIV were diagnosed at the same time. The proportion of patients with the lymphocyte count < 50 cells/μl was twice larger among males than females. Besides, patients with the viral load ≥ 500 000 copies per mL of blood were more frequently detected among males than females. Patients on HAART (highly active antiretroviral therapy) were more frequently found among females than males. Conclusion. Sociodemographic characteristics and the clinical course of both TB and HIV infection have gender-related features in patients with TB/HIV co-infection.