[Diagnosis of tuberculous pericarditis in patients with HIV-infection].
OBJECTIVE
To study specific features of the incidence, course and diagnosis of tuberculosis pericarditis (TP) in patients with HIV-infection.


METHODS
We analysed results of diagnosis of 304 primary patients with organ tuberculosis in combination with HIV infection treated in Moscow tuberculosis hospital N 7 in 2006-2010. CD4 lymphocyte count median in tuberculosis onset was 140 in 1 mcl, 63.2% patients had a baseline level of CD4 lymphocytes under 200 in 1 mcl.


RESULTS
TP incidence in primary patients with tuberculosis and HIV-infection was 6.3% while in patients with tuberculosis of multiple locations--13.7%. Cardiac tamponade symptoms were registered only in one case. Pericardial effusion was classified as moderate and large in 68.4% patients. Patients with large effusion (more than 20 mm in isolation of pericardial leaves) have undergone diagnostic pericardiocentesis and, in some cases, microdrainage. Sensitivity of exudate test for M. tuberculosis DNA with use of polymerase chain reaction was 100%.


CONCLUSIONS
Active surgical policy in massive effusion tuberculosis pericarditis in line with adequate antituberculosis and antiretrovirus therapy in HIV-infected patients results in rapid resorption of the effusion.
M V
MV
Toshchevikov
V N
VN
Zimina
F A
FA
Batyrov
A V
AV
Kravchenko
I A
IA
Vasil'eva
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D004269:DNA, Bacterial / Q000302:isolation & purification; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009031:Moscow; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010490:Pericardial Effusion / Q000209:etiology* / Q000628:therapy; D010495:Pericarditis, Tuberculous / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity
D019380:Anti-HIV Agents; D000995:Antitubercular Agents; D004269:DNA, Bacterial