RESUMO
The epidemiological HIV infection situation in the Ukraine in the past 4 years is analyzed. In patients with AIDS, the clinical manifestations of tuberculosis are atypical; prolonged intoxication, negative tuberculin tests, no bacterial isolation in half the cases. These patients should be treated with 4 - 5 antituberculous drugs, by taking into account the fact that only long-term continuous therapy may yield a positive effect.
PIP: In the Ukraine, the first case of HIV infection was reported in 1987 and, by the end of 1992, the number rose to 112 cases, 12 of which developed AIDS. By mid-1996, about 4500 HIV-positive cases were known to exist and there were 73 known AIDS patients, of which 40 died. Another cause for concern is the resurgence of tuberculosis (TB) and, in particular, TB in combination with HIV infection. There were 177.8 double infection cases/100,000 population in the country according to recent statistical data versus 38.7 TB cases/100,000 population in the general population. The first 8 cases of double infection were reported in 1991. TB is commonly treated with the following drugs: 5-10 mg/kg isoniazid; 10 mg/kg ethambutol or 25 mg/kg pyrazinamide; 15 mg/kg streptomycin or 15 mg/kg kanamycin. AIDS is treated with azidothymidine, dextransulfate, and by the implantation of lymphocytes for the restoration of immune function. The observation period of the 8 patients infected with TB and HIV lasted from 4-5 months to 2 years, during which time intensive therapy consisted of 4-5 preparations. Post-TB sequelae, such as fibrous inflammation in the lungs, should be treated with 5 mg/kg isoniazid for 3 months twice a year. The traditional diagnosis of TB relies on negative TB tests, atypical X-ray images, and the presence of Mycobacterium tuberculosis in more than 50% of the patients.
