Opportunistic infections in patients with lung tuberculosis
Alexey Shibanov1, Vladimir Stakhanov2, Natalia Karazhas3, Maria Kornienko3, Maria Kalugina3 and Tatiyana Rybalkina3
1Lung Tuberculosis Diagnostic Department, Moscow Town Tuberculosis Clinic No 3 Named by G.A.Zakharin, Moscow, Russian Federation, 2TB Department, Pirogov Russian National Research Medical University, Moscow, Russian Federation, 3Opportunistic Epidemiology Department, Gamaleya Federal Research Center of Microbiology, Immunology and Virusology, Moscow, Russian Federation
Introduction: Wide spread of opportunistic infections (OI) among immunosuppressive patients is actual problem at present because of high mortality in such patients.
Aim of the study: Frequency estimation of OI — Herpes virus (HV) and Pneumocystis jirovecii (PC) — in patients with lung tuberculosis with or without HIV-infection.
Methods: 102 patients with lung tuberculosis were examined, 73 (71,6%) — with HIV-infection, 29 (28,4%) — without HIV-infection. Diagnosis of tuberculosis was made on the results of clinical and X-ray examination. All patients with HIV-infection had clinical category C1-C3. Samples of blood were tested with immunoferment analysis to detect the quantitative rate of antibodies IgM and IgG in serum for cytomegalovirus (CMV), HV type 1 and 2, virus Epstein-Barr (EBV), HV type 6 and PC.
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Results: Analysis of frequency rates of OI in patients with lung tuberculosis without HIV-infection showed that CMV was tested in 41,4%, HV 1 — in 86,2%, EBV — in 55,2%, HV 6 — in 20,7%, PC — in 34,5%. Similar results were gained in group with HIV-infection. Algorithm was developed to estimate the activity of OI depending on laboratory data. The main indicator of activity was simultaneously increased levels of antibodies IgM and IgG in samples of blood serum. According to this algorithm acute phase of CMV was tested in 8,6% of patients, HV 1 — 33,3%, PC — 18,8%.
Conclusions: Frequency of OI in patients with lung tuberculosis is rather high and doesn't correlate with HIV-infection presence. High levels of markers of HV and PC in such patients require more detailed examination to detect the role of OI in main disease currency, efficiency and duration of therapy and prognosis for the patients.
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