ABSTRACT
The article is devoted to the global problems of modern medicine - HIV infection and the COVID-19 pandemic. The review of the literature highlights current ideas about the pathogenesis and course of COVID-19 in patients with HIV infection, and also touches upon the problems of concomitant pathology and mental health of patients with HIV in the setting of the COVID-19 pandemic. It has been shown that HIV-positive patients are a risk group for the severe course of COVID-19, in particular, individuals with severe immunodeficiency (CD4+ T lymphocytes 200 cells/l) due to the development of synergetic lung damage by SARS-CoV-2 and secondary infectious agents such as cytomegalovirus and Pneumocystis carinii. It has been proven that one of the targets of the SARS-CoV-2 virus is CD4+ T cells, which in COVID-19 leads to a more rapid progression of immunodeficiency in patients with HIV infection and, thus, significantly increases the risk of secondary diseases and death. Particular attention should be paid to middle-aged and elderly people living with HIV, who, compared with HIV-negative patients, are more likely to have concomitant pathology - arterial hypertension, cardiomyopathy and diabetes mellitus, which are the risk factors for severe COVID-19. The results of studies on the effect of antiretroviral drugs on the course of COVID-19 showed that HIV-infected patients receiving tenofovir + emtricitabine have a lower risk of severe COVID-19 and associated hospitalization than patients receiving other HIV treatment regimens. Clinical and preclinical data support the potential use of tenofovir in the treatment of novel coronavirus infection.
ABSTRACT
The objective: to study clinical and laboratory specific parameters of the COVID-19 course in patients with TB/HIV co-infection, to analyze changes in the lungs caused by COVID-19 in patients with pulmonary tuberculosis and concurrent HIV infection. Subjects and Methods. 68 HIV-infected patients aged 18-66 years old were included in the study, they all were admitted to the Novosibirsk State Regional Clinical Tuberculosis Hospital, Novosibirsk, with confirmed COVID-19 from May 2020 to May 2021. Clinical manifestations, CD4 count and HIV RNA level, and the presence of secondary infections were assessed. Results. In patients with severe and profound immunodeficiency, coronavirus infection was more often mild to moderate, and in immunocompetent patients - moderate to severe. However, patients with profound immunodeficiency were at greater risk of an adverse outcome due to lymphohematogenic progression of tuberculosis and concurrent opportunistic infections. Conclusion. When diagnosing and treating COVID-19 in patients with comorbid HIV infection and tuberculosis, it is important to consider the form of tuberculosis and CD4+ count. © 2022 New Terra Publishing House. All rights reserved.