Comorbid conditions as a cause of adverse outcome of HIV infection
https://doi.org/10.34680/2076-8052.2022.1(126).10-14
Abstract
The paper presents a retrospective analysis of the medical histories and pathoanatomic protocols of all deceased HIV-infected patients (n = 209) who received specialized medical care in the Novgorod Regional Infectious Diseases Hospital. The study was conducted for 14 years, from the moment the specialized department for HIV-infected patients was established until 2018. There is an increase in the number of HIV-infected patients in need of specialized inpatient care in the region. The reasons are the following: an insufficiently high proportion of patients registered at the dispensary with diagnosed HIV infection (79%); a high proportion (18,7%) of newly diagnosed patients; extremely low coverage (11,9%) of antiretroviral therapy, its late initiation and poor adherence. Against the background of the progression of HIV infection and the development of comorbid conditions, the mortality rate of HIV-infected patients in the hospital is increasing. Of the comorbid conditions, the following predominate: tuberculosis (20,1%), pneumocystis pneumonia (19,6%), cirrhosis of the liver (14,8%), sepsis (11,5%), cerebral toxoplasmosis (7,18%), cytomegalovirus infection (4,31%) and cerebral cryptococcosis (1,44%). Moreover, most of the listed diseases have specific prevention, which was not carried out in the cases of the patients due to late detection of HIV infection, untimely seeking medical care, and low adherence to dispensary registration and antiretroviral therapy.
About the Authors
O. V. Azovtseva
Новгородский государственный университет имени Ярослава Мудрого
Russian Federation
Russian Federation
N. A. Beliakov
Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова
Russian Federation
Russian Federation
References
1. Beliakov N. A., Rassokhin V. V., Trofimova T. N., Stepanova E. V., Panteleev A.M., Leonova O. N., Buzunova S. A., Konovalova N. V., Milichkina A.M., Totolyan A. A. Komorbidnyye i tyazhelyye formy VICH-infektsii v Rossii // VICH-infektsiya i immunosupressii [Comorbid and severe forms of HIV infection in Russia]. VICH-infektsiya i immunosupressii – HIV infection and immunosuppression, 2016, vol. 8, no. 3, pp. 9-25. doi: 10.22328/2077-9828-2016-83-9-25
2. Beliakov N.A., Rassokhin V.V., Bobkova M.R., et al. Komorbidnyye sostoyaniya pri VICH-infektsii. Ch. I. Osnovy problemy [Comorbid conditions in HIV infection. Part I. The basics of the problem]. St. Petersburg, Baltiyskiy Medical Education Center Publ., 2018. 184 p.
3. Beliakov N. A., Rassokhin V. V., Azovtseva O.V. Comorbid conditions in HIV infection. Part II. Secondary and concomitant infections [Komorbidnyye sostoyaniya pri VICH-infektsii. Ch. II. Vtorichnyye i soputstvuyushchiye infektsii]. St. Petersburg, Baltiyskiy Medical Education Center Publ., 2019. 252 p.
4. Belyalov F. I. Dvenadtsat' tezisov komorbidnosti [Twelve theses of comorbidity]. Klinicheskaya medicina – Clinical medicine, 2009, vol. 12, pp. 69-71.
5. Borodulina E. A., Tsygankova I. L., Borodulin E. E., Vdoushkina E. S., Borodulina E. V. Narkomaniya, VICH, tuberkulez. Osobennosti mul'timorbidnosti v sovremennykh usloviyakh [Drug addiction, HIV, tuberculosis. Features of multimorbidity in modern conditions]. Vestnik sovremennoy clinicheskoy mediciny – The Bulletin of Contemporary Clinical Medicine, 2014, vol. 7(4), pp. 18-21.
6. Leonova O. N., Stepanova E. V., Beliakov N. A. Tyazhelyye i komorbidnyye sostoyaniya u bol'nykh s VICH-infektsiyey: analiz neblagopriyatnykh iskhodov [Severe and comorbid conditions in patients with HIV infection: analysis of adverse outcomes]. VICH-infektsiya i immunosupressii – HIV infection and immunosuppression, 2017, vol. 9(1), pp. 55-64. doi: 10.22328/2077-9828-2017-9-1-55-64
7. Rassokhin V. V., Buzunova S. A., Vratskikh T. V., Panteleeva O. V., Toropov S. E., Totrova Z. M., Golubkin A. A., Orlov G. M., Beliakov N. A. Problema stareniya i invalidizatsii VICH-infitsirovannykh patsiyentov [The problem of aging and disability of HIV-infected patients]. VICH-infektsiya i immunosupressii – HIV infection and immunosuppression, 2015, vol. 7(1), pp. 7-15. doi: 10.22328/2077-9828-2015-7-1-7-15
8. Leonova O. N., Vinogradova T. N., Sizova N. V., Stepanova E. V. Problemy lecheniya bol'nykh s tyazhelymi formami VICH-infektsii [Problems of treatment of patients with severe forms of HIV infection]. VICH-infektsiya i immunosupressii – HIV infection and immunosuppression, 2013, vol. 5(2), pp. 58-65.
9. Centers for Disease Control and Prevention. Advancing HIV prevention: new strategies for a changing epidemic. United States, 2003, MMWR, 2003, vol. 52(15), pp. 329-332. Available at: http://www.cdc.gov/mmwr/PDF/wk/mm.5215.pdf
10. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. November 3, 2008. 146 р. Available at: https://clinicalinfo.hiv.gov/sites/default/files/guidelines/archive/AdultandAdolescentGL001226.pdf
Review
For citations:
Azovtseva O.V., Beliakov N.A. Comorbid conditions as a cause of adverse outcome of HIV infection. Title in english. 2022;(1(126)):10-14. (In Russ.) https://doi.org/10.34680/2076-8052.2022.1(126).10-14
Views:
60
Email this article 