Efficiency of X-ray screening in detecting tuberculosis in HIV-infected patients


DOI: https://dx.doi.org/10.18565/epidem.2018.2.36-41

Masterova I.Yu., Zimina V.N., Gavrilov P.V., Shilova N.L., Zaitseva E.V., Shlykova L.A.

1 Saint Petersburg Research Institute of Phthsiopulmonology, Ministry of Health of Russia, Saint Petersburg, Russia; 2 Medical Sanitary Unit Seventy-Eight, Federal Penitentiary Service, Saint Petersburg, Russia; 3 Peoples’ Friendship University of Russia, Moscow, Russia
Objective. To investigate the efficiency of elective chest X-ray in detecting tuberculosis (TB) in individuals with different HIV status, who are confined in a penal colony (PC).
Subjects and methods. The results of 11,889 elective X-ray films were analyzed in 7,566 (63.64%) and 4,323 (36.36%) non-HIV- and HIV-infected prisoners, respectively, from PC Seven, Federal Penitentiary Service in Saint Petersburg and the Leningrad Region.
Results. During 4-year follow-up, TB cases were revealed in 154 people, including 45 (29.2%) and 109 (70.8%) cases among non-HIV- and HIV-infected patients, respectively. Among all the TB patients seeking medical advice, the proportion of HIV-infected persons was 87.5%. Semiannual X-ray screening allowed tuberculosis to be detected in only 55.0% of the HIV-infected patients and in only 45.5% of the patients with a CD4 lymphocyte concentration less than 200 cells/µl. Among the people without obvious immunodeficiency (with CD4 count more than 200 cells/µl), the proportion of patients detected during screening was 70.8%, which was lower than that in the group of non-HIV-infected TB patients (84.4%).
Conclusion. Elective semiannual X-ray is an insufficient tool to detect most cases of tuberculosis in people living with HIV, especially in those with immunodeficiency.
Keywords: screening for tuberculosis, HIV/TB co-infection, respiratory organ tuberculosis, chest X-ray, HIV infection
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For citations: Masterova I.Yu., Zimina V.N., Gavrilov P.V., Shilova N.L., Zaitseva E.V., Shlykova L.A. Efficiency of X-ray screening in detecting tuberculosis in HIV-infected patients. Èpidemiologiâ i infekcionnye bolezni. Аktual’nye voprosy 2018; (2):36–41


About the Autors

For correspondence:
Vera N. Zimina, MD, Professor, Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Peoples’ Friendship University of Russia
Address: 6, Miklukho-Maklay St., Moscow117198, Russia
Telephone: + 7(495) 365-25-33
E-mail: zimina_vn@rudn.university; vera-zim@yandex.ru
Information about the authors:
Irina Yu. Masterova, Postgraduate Student, Saint Petersburg Research Institute of Phthisiopulmonology, Ministry of Health of Russia; Phthisiatrician, Branch Seven, Medical Sanitary Unit Seventy-Eight, Russian Federal Penitentiary Service, Saint-Petersburg, Russia; e-mail: imast3_02@mail.ru
Pavel V. Gavrilov, Cand. Med. Sci., Leading Researcher, Supervisor of the Area «Radiation Diagnosis», Saint - Petersburg Research Institute of Phthisiopulmonology, Ministry of Health of Russia, Saint-Petersburg, Russia; e-mail: spbniifrentgen@mail.ru
Natalya L. Shilova, Phthisiatrician, Lieutenant Colonel of Internal Service, Chief, Tuberculosis Hospital One, Medical Sanitary Unit Seventy-Eight, Russian Federal Penitentiary Service, Saint-Petersburg, Russia; e-mail: gugles1970@mail.ru
Elena V. Zaуtceva, Cand. Med. Sci., Phthisiatrician, St. Petersburg Research Institute of Phthisiopulmonology, Ministry of Health of Russia, Saint-Petersburg, Russia; e-mail: e.v.zaiceva@mail.ru
Ludmila A. Shlykova, Phthisiatrician, Deputy Chief for Clinical Work, Tuberculosis Hospital One, Medical Sanitary Unit Seventy-Eight, Russian Federal Penitentiary Service, Saint-Petersburg, Russia; e-mail: luar56@mail.ru


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