Viral, but not-COVID pneumonia in patients with HIV infection


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Objective. To describe the pathogenetic, clinical, and radiological features and to determine the clinical value of cytomegalovirus (CMV) DNA viral load in respiratory biomaterials and blood in CMV pneumonia in patients with HIV infection. Subjects and methods. A total of 5485 HIV-infected patients (61.6% of cases had a CD4+lymphocyte count of < 200 cells/pl) were followed up; 593 people died. The investigators examined biomaterials for and determined the amount of pathogen DNA in secondary diseases, including CMV. Associations between the copy numbers of CMV DNA in the biomaterials and the presence of CMVpneumonia were sought for, by using the receiver operating curve (ROC) analysis. Results. CMV pneumonia was detected in 343 (14.4%) of the 2376 cases of lung diseases. The paper presents the clinical and radiological characteristics of CMV lung lesions and describes their morphopathological features. It notes a statistically significant relationship between the HIV RNA viral load in blood, the indicators of the cellular component of immunity, and the amount of CMV DNA in the biomaterials, the probability of developing CMV pneumonia. According to the findings, CMV DNA >2.95 log in 105 leukocytes, > 9000 copies/ml in plasma, > 25 000 copies/ml in bronchoalveolar lavage, > 3500 copies in 105 cells in bronchial tissue samples and > 20 000 copies/ml in sputum confirm the diagnosis of CMV pneumonia with 95% probability. Conclusion. Late-stage CMV pneumonia is a common and severe problem in HIV-infected patients. Viral load assessment in blood and respiratory samples plays a key role in correct diagnosis.

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作者简介

Vasily Shakhgildyan

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: vishakh@yandex.ru
Cand. Med. Sci., Senior Researcher

Marina Yadrikhinskaya

Moscow City Center for AIDS the Prevention and Control

Email: rusalo4ka_88@mail.ru
Resident Physician

Aleksey Orlovsky

M.V. Lomonosov Moscow State University

Email: leha-orl@yandex.by
Laboratory Researcher, Laboratory for monitoring programs for Reduction of Mortality from Cardiovascular Diseases

Elvira Domonova

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: lvira.domonova@pcr.ms
Cand. Biol. Sci., Head, Scientific Group for New Methods to Diagnose Opportunistic and Human Papillomavirus Infections, Department of Molecular Diagnosis and Epidemiology

Olga Shipulina

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: olga.shipulina@pcr.ms
Cand. Med. Sci., Molecular Diagnostics Department

Oleg Tishkevich

Clinical Infectious Diseases Hospital Two, Moscow Healthcare Department

Email: tishol@mail.ru
Pathologist

Tatiana Ermak

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: t.ermak@hiv-russia.ru
MD, Leading Research

Elena Yarovaya

M.V. Lomonosov Moscow State University

Email: yarovaya@mech.math
Doctor of Physical and Mathematical Sci., Professor, Department of Probability Theory, Faculty of Mechanics and Mathematics

参考

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