Anemic syndrome and its features in patients with disseminated pulmonary tuberculosis and HIV infection


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Currently, the Incidence of HIV infection and pulmonary tuberculosis (PT) comorbidlty is Increasing, with disseminated PT making up a major proportion In the pattern of clinical forms of PT. Anemic syndrome is one of the possible complications of both tuberculosis and HIV infection. Objective: to Investigate the features of anemic syndrome In patients with disseminated PT/HIV infection comorbidlty. Subjects and methods. The investigation enrolled 42 patients with HIV Infection and disseminated PT. The patients' clinical and social characteristics were studied; the values of a general blood test were analyzed. Serum Iron, ferritin, and hepcidin levels were additionally determined. Statistical data were processed using the MedCalc 19.2.6 statistical software program. Results The patients with HIV infection and disseminated PT were found to have anemia, mainly hypo- or normochromic moderate anemia, In half of the cases. There was a preponderance of anemia of chronic disease (47.6%), mixed anemia (38.1%), whereas true iron deficiency anemia was rare (4.8%). Conclusion. The findings may further contribute to the choice of tactics for the correction of anemic syndrome in patients with HIV infection and disseminated PT.

Full Text

Restricted Access

About the authors

E. V Yakovleva

Samara State Medical University, Ministry of Health of Russia

Email: elena130894@mail.ru

References

  1. Вдоушкина Е.С., Бородулина ЕА., Калинкин А.В. и др. Туберкулез у больных ВИЧ-инфекцией в регионе с высоким распространением ВИЧ. Туберкулез и болезни легких. 2018; 96 (12): 64-5 [Vdoushkina E.S., Borodulina ЕЛ., Kalinkin A.V. et al. Tuberculosis in HIV patients in the region with high HIV prevalence. Tuberculosis and Lung Diseases. 2018; 96 (12): 64-5 (in Russ.)]. doi: 10.21292/2075-1230-2018-96-12-64-65
  2. Бородулина ЕЛ., Инькова A.T., Бородулин Б.Е. и др. Пути оптимизации выявления туберкулеза в пульмонологическом отделении. Туберкулез и болезни легких. 2018; 96 (5): 22-7 [Borodulina Е.А., InkovaA.T., Borodulin В.Е., Povalyaeva L.V. Ways to optimize detection of tuberculosis in a pulmonology unit. Tuberculosis and Lung Diseases. 2018; 96 (5): 22-7 (in Russ.)]. doi: 10.21292/2075-1230-2018-96-5-22-26
  3. Бородулина E.A., Яковлева E.B. Диссеминированный туберкулез легких: современные аспекты. Наука и инновации в медицине. 2017; 2 (2): 39-43 [Borodulina ЕЛ., Yakovleva E.V. Disseminated pulmonary tuberculosis: actual problems. Science and Innovations In Medicine. 2017; 2 (2): 39-43 (in Russ.)]. doi: 10.35693/2500-1388-2017-0-2-39-43
  4. Илькович M.M., Новикова Л.Н., Илькович Ю.М. Противоречия в представлениях об интерстициальных заболеваниях легких. Докгор.Ру. 2013; 8 (86): 41-5 [ll’kovich М.М., Novikova L.N., ll'kovich Yu.М. Discrepancies in Understanding Interstitial Lung Disease. Doktor.Ru. 2013; 8 (86): 41-5 (in Russ.)].
  5. Мишин В.Ю., Эргешов А.Э., Мишина А.В. Диагностика и дифференциальная диагностика диссеминированных поражений легких у больных с ВИЧ-инфекцией (обзор). Consilium Medlcum. 2018; 20 (3): 8-13 [Mishin V.Yu., Ergeshov A.E., Mishina A.V. Diagnosis and differential diagnosis of disseminated lung lesions in patients with HIV infection (review). Consilium Medlcum. 2018; 20 (3): 8-13 (in Russ.)]. doi: 10.26442/2075-1753_20.3.8-13
  6. Бородулина E.A., Вдоушкина E.C., Инькова A.T. Туберкулез легких у больных ВИЧ-инфекцией. Врач. 2020; 31 (1): 37-43 [Borodulina Е., Vdoushkina Е., Inkova A. Tuberculosis and HIV-infection. Vrach. 2020; 31 (1): 37-43 (in Russ.)]. doi: 10.29296/25877305-2020-01-07
  7. Каминский Г.Д., Кудлай ДА., Панова А.Е. и др. Тактика врача при выявлении, диагностике и профилактике сочетанной инфекции ВИЧ и туберкулез. Практическое руководство. Под ред. ИЛ. Васильевой. М., 2020; 152 с. [Kaminski! G.D., Kudlai D.A., Panova А.Е. et al. Taktika vracha pri vyyavlenii, diagnostike i profilaktike sochetannoi infektsii VICh I tuberkulez. Prakticheskoe rukovodstvo. Pod red. 1Л. Vasil’evoi. М., 2020; 152 s. (in Russ.)].
  8. Кудлай ДЛ. Биомаркеры и иммунологические тесты. Экспериментальноклинические параллели латентной туберкулезной инфекции. Туберкулез и болезни легких. 2020; 98 (8): 63-74 [Kuday D.A. Biomarkers and immunological tests. Experimental and clinical parallels of latent tuberculosis infection. Tuberculosis and Lung Diseases. 2020; 98 (8): 63-74 (in Russ.)]. http://doi. org/10.21292/2075-1230-2020-98-8-63-74
  9. Cardona P.J. Pathogenesis of tuberculosis and other mycobacteriosis. Enfermlnfec Microbiol Clin. 2018; 36 (1): 38-46. doi: 10.1016/j.eimc.2017.10.015
  10. Sharma S., Nahar U., Das A. et al. Acute respiratory distress syndrome in disseminated tuberculosis: an uncommon association. IntJ Tuberc Lung Dis. 2016; 20 (2): 271-5. doi: 10.5588/ijtld.15.0357
  11. Abreu R., Essler L., Loy A. et al. Heparin inhibits intracellular Mycobacterium tuberculosis bacterial replication by reducing iron levels in human macrophages. SciRep. 2018; 8 (1): 72-96. doi: 10.1038/s41598-018-25480-y
  12. Mendonça E.B., Schmaltz С.A., Sant’Anna F.M. et al. Anemia in tuberculosis cases: A biomarker of severity? PLoS One. 2021; 16 (2): 54-8. DOI: 10.1371/ journal.pone.0245458
  13. Агафонова O.B., Гриценко ТЛ., Богданова Ю.В. и др. Поликлиническая терапия: Учебник. Под ред. Д.И. Давыдкина, Ю.В. Щукина. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа, 2020; 840 с. [Agafonova O.V., Gritsenko Т.А., Bogdanova Yu.V. et al. Poliklinicheskaya terapiya: Uchebnik. Pod red. D.l. Davydkina, Yu.V. Shchukina. 2-e izd., pererab. i dop. М.: GEOTAR-Media, 2020; 840 s. (in Russ.)] doi: 10.33029/9704-5545-6-PLT-2020-1-840
  14. Андреичев H.A., Балеева Л.В. Анемия хронических заболеваний. Российский медицинский журнал. 2014; 20 (2): 50-5 [Andreitchev NA, Baleyeva L.V. Anemia of chronic diseases. Medical Journal of the Russian Federation. 2014; 20 (2): 50-5 (in Russ)].
  15. Сахин B.T., Крюков E.B., Рукавицын 0A Анемия хронических заболеваний - особенности патогенеза и попытка классификации. Тихоокеанский медицинский журнал. 2019; 1: 33-7 [Sakhin V.T., Kryukov E.V., Rukavitsyn О.А. Anemia of chronic diseases - the key mechanisms of pathogenesis and the attempt of the classification. Pacific Medical Journal. 2019; 1: 33-7 (in Russ.)]. doi: 10.17238/Pm J1609-1175.2019.1.33-37
  16. Erika P., Margherita М., Motta I. Anemia of chronic disease: a unique defect of iron recycling for many different chronic diseases. Eur J Intern Med. 2014; 25 (1): 12-7. doi: 10.1016/j.ejim.2013.07.011
  17. Cassat J.E., Skaar E.P. Iron in infection and immunity. Cell Host Microb. 2013; 13 (5): 509-19. doi: 10.1016/j.chom.2013.04.010
  18. Kerkhoff A.D., Meintjes G., Burton R. et al. Relationship between blood concentrations of hepcidin and anemia severity, mycobacterial burden, and mortality among patients with HIV-associated tuberculosis. Infect Dis. 2016; 213 (1): 61-70. doi: 10.1093/infdis/jiv364

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2021 Russkiy Vrach Publishing House