features of a current of a tuberculosis, sochetannogo from a HIV - an infection at different level of the maintenance With І) 4-cells in peripheric blood
The analysis of structure of clinical forms of a tuberculosis testifies that all forms of a primary tuberculosis are diagnosed for children with a HIV-infection, as well as at sick of a tuberculosis without an infection HIV-.
However imeyoli a place appreciable differences in development of complications and generalisation tuyoberkuleznogo process depending on at what stage of a HIV - of an infection the tuberculosis, so from degree of oppression of immune system of an organism (from maintenance CD4 +-limfotsitov), as a stage of secondary diseases svjazanna with attrition of population CD4+лимфоцитов developed.Depression of immunity at sick HIV-infections of children (especially at absence antiretrovirusnoj therapies) does incapable an organism of these patients to delimit tubercular process to interfere with repeated bacteriemias and a dissimination of micobacteria in various organs and tissues.
We have studied features of a current and structure of clinical forms tuyoberkuleza at children, sick HIV-infections, depending on level CD4 + - lymphocytes in peripheric blood.
As criteria of an estimation of gravity of an immunodeficiency at children from a HIV - an infection used classification CDC on immunologic and kliyonicheskim to criteria 1994г. (Table 5.5). Recommend to define not only absolute number CD4, but also and their share from the general number of lymphocytes as at children in norm number CD4 gradually decreases and approximately to 6
To 8 years becomes same, as at adults. These age izyomenenija affect share CD4 in a smaller measure.
Table 5.5 Classification of a HIV-infection at children: immunologic stages of a HIV - of an infection according to number and a share of lymphocytes CD4 at children of different age.
(The reconsidered classification of 1994 *)