Features of tissue reactions of immunocompetent organs in disseminated tuberculosis at different stages of HIV infection

Abstract

The purpose of the study. The improvement of the diagnosis oftuberculosis in HIV-infected patients on the basis ofa comparative study of tissue reactions of immunecompetent organs in disseminated tuberculosis and changes of the immunological status at different stages of HIV infection. Materials and methods. Pathological studies were performed on autopsy material of 11 cases oftuberculosis with HIV infection, and 6 autopsy observations of HIV infection. Studies of indices of the immunological response was performed in 60 patients with disseminated pulmonary tuberculosis (DPT) agedfrom 18 to 49 years, associated with HIV infection - 30 people (DPT + HIV) - the first group; and DPT without HIV infection - 30 people - the second group. The result of the study Progression of tuberculosis in patients on the background of HIV infection leads to the death both at the early and late stages of HIV infection. Histopathological features of lymphoid tissue response to tubercular process, depending on the stage of HIV infection were revealed. The structure of the granulation tissue of immunocompetent organs forming even at the terminal stage of the course of HIV infection testifies to the presence of residual immunological reserves. Damage to the immune system in tuberculosis and HIV infection has an systemic manifesting by a deep suppression of T- and B- cellular components of the immune system. In the course of HIV infection in patients with disseminated tuberculosis regular there are in process changes of quantitative and qualitative indices of the cellular component of l immunity, humoral immunity, nonspecific protection factors, and the functional activity ofneutrophils. Along with a decline in the number of CD4+ lymphocytes, the serum level of immunoglobulins and circulating immune complexes increases. Immunodeficiency determines a more severe course of tuberculosis. Conclusion The evaluation of the immune status and pathologic response of lymphoid tissue in patients with tuberculosis and HIV infection is needed for the diagnosis of the stage of the process, the choice of the method of the treatment, the estimation of its effectiveness and outcome prediction for the disease

Keywords

pulmonary tuberculosis / HIV infection / immunological profile / pathomorphology / lymph nodes / spleen / outcome prediction

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