MEDICAL AND SOCIAL ISSUES OF PATIENTS NEWLY DIAGNOSED WITH TUBERCULOSIS IN THE LATE STAGES OF HIV-INFECTION

In this article authors team explored medical and social aspects in patients newly diagnosed with tuberculosis in the late stages of HIV-infection. For this purpose, we examined 101 patients with newly diagnosed pulmonary tuberculosis combined with HIV- infection. Two groups were formed: the first group - 60 patients with high adherence to treatment (courses of TB (PTT), antiretroviral therapy (ART), in the presence of toxic and allergic reactions - plasmapheresis (PA) in the development of severe destructive forms of tuberculosis with massive smear and inefficient course of the intensive phase of PTT-intravenous laser irradiation of blood (VLOK); the second group - 41 patients with low adherence to treatment (only PTT and ART were performed, patients refused PA and VLOK). The results revealed the most significant social factors affecting adherence to treatment in patients with co-infection (TB / HIV), also showed their effect on the effectiveness of the anti-TB and antiretroviral therapy. Based on these results the following conclusions have been made: 1. The social conditions (residence, the presence of living space, families and children, the nature of household contacts, type of education, employment, criminal record and antisocial habits) affect adherence to antiretroviral and anti-TB treatment in TB patients with advanced HIV-infection. 2. In socially adapted patients with stable high motivation and commitment to treatment in the presence of new-onset tuberculosis in the late stages of HIV-infection, it is possible to achieve clinical efficacy, positive X-ray laboratory dynamics and relief of adverse events. 3. Adverse social factors, causing maladjustment of the individual in society, reduce motivation and commitment to treatment, contribute to the low efficiency of anti-TB and antiretroviral therapy in patients with co-infection (TB / HIV) and impair the vital prognosis.

туберкулез, ВИЧ-инфекция, социальные факторы, tuberculosis, HIV infection, social factors

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