The epidemiological, clinical, and diagnostic aspects of tuberculosis concurrent with HIV infection in the Republic of Guinea

Objective. To study the epidemiological, clinical, and diagnostic aspects of tuberculosis (TB) concurrent with HIV infection in the Republic of Guinea. Subjects and methods. A total of 646 patients with lung diseases partially associated with HIV infection were examined in the healthcare facilities of Kindia, Dubreka, and Conakry (Republic of Guinea). Pulmonary TB was diagnosed by microscopy, culture, and X-ray study. The patients’ blood HIV antibodies were determined by an enzyme immunoassay and confirmed by Western blotting. The epidemiological, clinical, and diagnostic aspects of these concomitant diseases were assessed. Results. Pulmonary TB was diagnosed in 200 patients. It was found that there were HIV-1 (80%), HIV-2 (15%), and HIV-3 (5%) strains. The proportion of patients with HIV infection concurrent with TB in the healthcare facilities was 50% in Kindia, 17.2% in Dubreka, and 15.7% in Conakry. Among the patients there were slightly more women, the latter (housewives) prevailed among 11 social and professional groups of patients. Persons aged 15-44 years are at the greatest risk of infection. The patients had typical clinical signs of TB. X-rays revealed a predominant shadow of the lung base (40%). Among concomitant diseases, tropical malaria (69.4%) and intestinal parasitoses (40%) were predominant in TB patients at the Conakry hospital. Among opportunistic infections, there was anemia (92.4%), candidiasis of the gastrointestinal tract (61.2%), dermatosis (3.5%), toxoplasmosis (3.5%), and Kaposi’s sarcoma (2.3%). Conclusion. Since the classical techniques for TB diagnosis are laborious, low-sensitive, and insufficiently specific, modern PCR diagnostic methods are most promising. But they are still unavailable in the country due to their high cost and a lack of trained of medical staff. In the future, the Research Institute of Applied Biology of the Republic of Guinea (RIABG) will master the new test systems developed in the State Research Center for Applied Microbiology and Biotechnology (Obolensk, Russia); all the more so as the RIABG employees have already undergone the training organized by the Federal Service for Supervision of Consumer Rights Protection and Human Well-Being of the Russian Federation. Genotyping of Mycobacterium tuberculosis isolates is scheduled, which will improve the quality of diagnosis of TB as a concomitant disease in HIV infection, as well as treatment regimens and TB epidemic surveillance in the Republic of Guinea.

tuberculosis, HIV infection, epidemiology, Republic of Guinea