Bacterial excretion in patients with HIV infection and tuberculosis


DOI: https://dx.doi.org/10.18565/epidem.2018.3.35-40

Viktorova I.B., Zimina V.N., Kravchenko A.V., Khanin A.L.

1 Novokuznetsk State Institute for Postgraduate Training of Physicians, Branch, Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia, Novokuznetsk, Russia; 2 Peoples’ Friendship University of Russia, Moscow, Russia; 3 Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia
Objective. To analyze the rate of bacterial excretion among new-onset patients with HIV infection concurrent with tuberculosis (HIV/TB) in Novokuznetsk.
Materials and methods. The rate of sputum TB pathogen detection using fluorescence microscopy and cultures on dense nutrient media was studied in all new-onset patients with respiratory TB and HIV infection who had been registered in Novokuznetsk in 2013–2014 (n = 362). 77.0% were men and 23.0% were women. Their mean age was 34.8 ± 8.1 years.
Results. Data on CD4 lymphocyte counts were available in 294 (79.0%) patients; the median CD4 lymphocytes were 185 cells/µl. Fluorescence sputum smear microscopy and cultures on dense nutrient media gave positive results in 58.6% and 64.1%, respectively. Bacterial excretion was more frequently recorded in severe immunosuppression (CD4 lymphocytes < 200 cells/µl; p < 0.05). The rate of primary multidrug resistance was 51.9%, and its presence did not depend on the degree of immunosuppression. Fatal outcomes were significantly more common in patients with sputum smear-positive bacterial excretion results (46.7%) than in those with negative ones (30.1%; p < 0.005).
Conclusion. Sputum TB pathogen was found by at least one of the phenotypic methods in 72.1% of the HIV-infected patients with new-onset respiratory TB. Bacterial excretion was more frequently found in patients with CD4 lymphocytes < 200 cells/µl. The primary multidrug resistance rate was 51.9%.
Keywords: multiple drug resistance, bacterial excretion, tuberculosis, HIV infection
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For citations: Viktorova I.B., Zimina V.N., Kravchenko A.V., Khanin A.L. Bacterial excretion in patients with HIV infection and tuberculosis. Èpidemiologiâ i infekcionnye bolezni. Аktual’nye voprosy 2018; (3):35–40


About the Autors

For correspondence:
Irina B. Viktorova, Сand. Med. Sci., Associate Professor, Department of Phthisiopulmonology, Novokuznetsk State Institute for Postgraduate Training of Physicians, Branch, Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Address: 5, Prospect Stroiteley, Novokuznetsk 654005, Russia
Telephone/fax: +7(3843)-45-42-19
E-mail: irinaviktoroff@mail.ru
ORCID: http://orcid.org/0000-0002-5826-5517
Information about the authors:
Vera N. Zimina, МD, Professor, Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Peoples’ Friendship University of Russia, Moscow, Russia; e-mail: vera-zim@yandex.ru; ORCID: http://orcid.org/0000-0003-3726
Prof. Alexey V. Kravchenko, МD, Leading Researcher, Federal Scientific and Methodological Center for AIDS Prevention and Control, Moscow, Russia; e-mail: kravtchenko@hivrussia.net; ORCID: http://orcid.org/0000-0001-7857-3763
Prof. Arkady L. Khanin, Сand. Med. Sci., Head, Department of Phthisiopulmonology, Novokuznetsk State Institute for Postgraduate Training of Physicians, Branch, Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia, Novokuznetsk, Russia; e-mail: prof.khanin@yandex.ru


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