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Medical Care for Tuberculosis-HIV-Coinfected Patients in Russia with Respect to a Changeable Patients’ Structure

To date, tuberculosis (TB) remains the primary cause of mortality in human immunodeficiency virus (HIV) patients in Russia. Since the beginning of 2000, a sharp change in the HIV patients’ structure, to the main known risk factors for HIV infection has taken place in Russia. The transmission of HIV...

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Autores principales: Frolova, Olga P., Butylchenko, Olga V., Gadzhieva, Patimat G., Timofeeva, Margarita Yu., Basangova, Valeria A., Petrova, Vladislava O., Fadeeva, Inna A., Kashutina, Maria I., Zabroda, Nadezhda N., Basov, Artem A., Belova, Elena V., Zhernov, Yury V., Mitrokhin, Oleg V., Enilenis, Inga I., Severova, Lyudmila P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9228798/
https://www.ncbi.nlm.nih.gov/pubmed/35736965
http://dx.doi.org/10.3390/tropicalmed7060086
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author Frolova, Olga P.
Butylchenko, Olga V.
Gadzhieva, Patimat G.
Timofeeva, Margarita Yu.
Basangova, Valeria A.
Petrova, Vladislava O.
Fadeeva, Inna A.
Kashutina, Maria I.
Zabroda, Nadezhda N.
Basov, Artem A.
Belova, Elena V.
Zhernov, Yury V.
Mitrokhin, Oleg V.
Enilenis, Inga I.
Severova, Lyudmila P.
author_facet Frolova, Olga P.
Butylchenko, Olga V.
Gadzhieva, Patimat G.
Timofeeva, Margarita Yu.
Basangova, Valeria A.
Petrova, Vladislava O.
Fadeeva, Inna A.
Kashutina, Maria I.
Zabroda, Nadezhda N.
Basov, Artem A.
Belova, Elena V.
Zhernov, Yury V.
Mitrokhin, Oleg V.
Enilenis, Inga I.
Severova, Lyudmila P.
author_sort Frolova, Olga P.
collection PubMed
description To date, tuberculosis (TB) remains the primary cause of mortality in human immunodeficiency virus (HIV) patients in Russia. Since the beginning of 2000, a sharp change in the HIV patients’ structure, to the main known risk factors for HIV infection has taken place in Russia. The transmission of HIV through injectable drug use has begun to decline significantly, giving way to the prevalence of sexual HIV transmission today. These changes may require adjustments to organizational approaches to anti-TB care and the treatment of HIV-positive patients. Our study is aimed at identifying changes in TB-HIV coinfection patients’ structures in 2019 compared to 2000. Based on the results obtained, our goal was to point out the parameters that need to be taken into account when developing approaches to improve the organization of TB control care for people with HIV infection. We have carried out a cross-sectional, retrospective, epidemiological study using government TB registry data from four regions in two federal districts of Russia in 2019. The case histories of 2265 patients from two regions with high HIV prevalence, which are part of the Siberian Federal District of Russia, and 89 patient histories from two regions of low HIV prevalence, which are part of the Central Federal District of Russia, were analyzed. We found that parenteral transmission (69.4%) remains the primary route of HIV transmission among the TB-HIV coinfected. The unemployed of working age without disability account for 80.2% of all coinfected people, while the formerly incarcerated account for 53.7% and the homeless account for 4.1%. Those with primary multidrug-resistant TB (MDR-TB) comprise 56.2% of HIV-TB patients. When comparing the incidence of coinfection with HIV among TB patients, statistically significant differences were obtained. Thus, the chances of coinfection increased by 4.33 times among people with active TB (95% CI: 2.31; 8.12), by 2.97 times among people with MDR-TB (95% CI: 1.66; 5.32), by 5.2 times in people with advanced processes in the lungs, including destruction, (95% CI: 2.78; 9.7), as well as by 10.3 times in the case of death within the first year after the TB diagnosis (95% CI: 2.99; 35.5). The absence of data for the presence of TB during preventive examination was accompanied by a decrease in the chances of detecting coinfection (OR 0.36; 95% CI: 0.2; 0.64). We have identified the probable causes of the high incidence of TB among HIV-infected: HIV-patient social maladaptation usually results in delayed medical care, leading to TB treatment regimen violations. Furthermore, self-administration of drugs triggers MDR-TB within this group. Healthcare providers should clearly explain to patients the critical importance of immediately seeking medical care when initial TB symptoms appear.
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spelling pubmed-92287982022-06-25 Medical Care for Tuberculosis-HIV-Coinfected Patients in Russia with Respect to a Changeable Patients’ Structure Frolova, Olga P. Butylchenko, Olga V. Gadzhieva, Patimat G. Timofeeva, Margarita Yu. Basangova, Valeria A. Petrova, Vladislava O. Fadeeva, Inna A. Kashutina, Maria I. Zabroda, Nadezhda N. Basov, Artem A. Belova, Elena V. Zhernov, Yury V. Mitrokhin, Oleg V. Enilenis, Inga I. Severova, Lyudmila P. Trop Med Infect Dis Communication To date, tuberculosis (TB) remains the primary cause of mortality in human immunodeficiency virus (HIV) patients in Russia. Since the beginning of 2000, a sharp change in the HIV patients’ structure, to the main known risk factors for HIV infection has taken place in Russia. The transmission of HIV through injectable drug use has begun to decline significantly, giving way to the prevalence of sexual HIV transmission today. These changes may require adjustments to organizational approaches to anti-TB care and the treatment of HIV-positive patients. Our study is aimed at identifying changes in TB-HIV coinfection patients’ structures in 2019 compared to 2000. Based on the results obtained, our goal was to point out the parameters that need to be taken into account when developing approaches to improve the organization of TB control care for people with HIV infection. We have carried out a cross-sectional, retrospective, epidemiological study using government TB registry data from four regions in two federal districts of Russia in 2019. The case histories of 2265 patients from two regions with high HIV prevalence, which are part of the Siberian Federal District of Russia, and 89 patient histories from two regions of low HIV prevalence, which are part of the Central Federal District of Russia, were analyzed. We found that parenteral transmission (69.4%) remains the primary route of HIV transmission among the TB-HIV coinfected. The unemployed of working age without disability account for 80.2% of all coinfected people, while the formerly incarcerated account for 53.7% and the homeless account for 4.1%. Those with primary multidrug-resistant TB (MDR-TB) comprise 56.2% of HIV-TB patients. When comparing the incidence of coinfection with HIV among TB patients, statistically significant differences were obtained. Thus, the chances of coinfection increased by 4.33 times among people with active TB (95% CI: 2.31; 8.12), by 2.97 times among people with MDR-TB (95% CI: 1.66; 5.32), by 5.2 times in people with advanced processes in the lungs, including destruction, (95% CI: 2.78; 9.7), as well as by 10.3 times in the case of death within the first year after the TB diagnosis (95% CI: 2.99; 35.5). The absence of data for the presence of TB during preventive examination was accompanied by a decrease in the chances of detecting coinfection (OR 0.36; 95% CI: 0.2; 0.64). We have identified the probable causes of the high incidence of TB among HIV-infected: HIV-patient social maladaptation usually results in delayed medical care, leading to TB treatment regimen violations. Furthermore, self-administration of drugs triggers MDR-TB within this group. Healthcare providers should clearly explain to patients the critical importance of immediately seeking medical care when initial TB symptoms appear. MDPI 2022-05-31 /pmc/articles/PMC9228798/ /pubmed/35736965 http://dx.doi.org/10.3390/tropicalmed7060086 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Communication
Frolova, Olga P.
Butylchenko, Olga V.
Gadzhieva, Patimat G.
Timofeeva, Margarita Yu.
Basangova, Valeria A.
Petrova, Vladislava O.
Fadeeva, Inna A.
Kashutina, Maria I.
Zabroda, Nadezhda N.
Basov, Artem A.
Belova, Elena V.
Zhernov, Yury V.
Mitrokhin, Oleg V.
Enilenis, Inga I.
Severova, Lyudmila P.
Medical Care for Tuberculosis-HIV-Coinfected Patients in Russia with Respect to a Changeable Patients’ Structure
title Medical Care for Tuberculosis-HIV-Coinfected Patients in Russia with Respect to a Changeable Patients’ Structure
title_full Medical Care for Tuberculosis-HIV-Coinfected Patients in Russia with Respect to a Changeable Patients’ Structure
title_fullStr Medical Care for Tuberculosis-HIV-Coinfected Patients in Russia with Respect to a Changeable Patients’ Structure
title_full_unstemmed Medical Care for Tuberculosis-HIV-Coinfected Patients in Russia with Respect to a Changeable Patients’ Structure
title_short Medical Care for Tuberculosis-HIV-Coinfected Patients in Russia with Respect to a Changeable Patients’ Structure
title_sort medical care for tuberculosis-hiv-coinfected patients in russia with respect to a changeable patients’ structure
topic Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9228798/
https://www.ncbi.nlm.nih.gov/pubmed/35736965
http://dx.doi.org/10.3390/tropicalmed7060086
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