results of treatment sick sochetannoj a pathology

We result results of treatment of the patients who were on treatment in clinic of scientific research institute FP (29 patients) as on them there are given rentgenoloyo
gicheskogo inspections, the immune status and a virus load in dinamiyoke.

Practically all children (86,2 %) left clinic with znachitelyonym improvement of a clinicoradiological picture of disease with polyonoj an involution of radiological signs of a dissimination and infiltrayotivnyh changes in a pulmonary tissue and intrathoracic lymph nodes (table 8.11).

Table 8.11

Clinical results of treatment sick of a tuberculosis, sochetannym with a HIV-infection

With moderate radiological dynamics in intrathoracic limyofaticheskih knots in 9 months of treatment 1 patient mikobakterioyozom with fastness NTMB almost to all preparations 1 and 2 numbers with rekomenyodatsijami treatment continuations is written out. At the next control in scientific research institute FP (in 9 months) good positive dynamics of process is noted. Other patient with a generalised neuroinfection (toxoplasmosis), pnevmotsistyonoj a pneumonia and an infection caused by complex Mycobacterium avium is translated in an infectious diseases hospital where the child has died of a progressing HIV-infection. One more child has died after an extract from clinic, was treated within 9 months apropos disseminirovannogo process (exacerbation), priyobyl in the Moscow area from Tajikistan where did not receive adequate leyochenija. It is written out with a full resorption of the centres of a dissimination and it is referred to an oncologic dispensary on a residence, as to the child of paral -

271 lelno it is diagnosed (gistologicheski) limfoma (nehodzhskinskaja). RodiYOteli have refused from lechenijai, the child has died in 5 months after an extract from scientific research institute FP.

Results of treatment were in many respects defined by a condition of the immune status and rising of CD4-lymphocytes in the course of treatment.

At entering in clinic more than at half sick (55,2 %) were observed depression CD4 various degrees (table 8.12), immunosuyopressija was mainly expressed and serious - in 41,4 % of cases. The median of CD4-lymphocytes at children with an immunodeficiency made to naznayochenija chemotherapies 251 cell in 1мкл (at patients without an immunodeficiency - 1509 cells in 1мкл).

In dynamics against antituberculous and antiretrovirusnoj terayopii quantity of patients with serious immunosupressiej has decreased in 5 times, the quantity of patients with moderate depression CD4 (from 13,8 % to 24,0 %) and on 7,2 % - with CD4> 500,> 25 % (from 44,8 % to 52,0 %) was enlarged by 10,2 %. Immunoyologichesky efficiency of treatment of a HIV-infection is defined povysheniyoem Cd4-limfotsitov more than on 30 % from initial level in 6 months from the treatment beginning (23,82, 180).

Table 8.12

Quantity CD4 (kl/mkl and %) before treatment and in dynamics against treatment by antituberculous and antiviral preparations