terms of revealing of a HIV-infection and appointment art

We have carried out the analysis of terms of revealing and a current of a HIV-infection at children sick of a tuberculosis which have entered into our research.

On our data trehetapnaja preventive maintenance of transfer of a HIV-infection from mother to the child is spent to 22,6 % of cases (appointment antiretrovirusyonyh preparations during pregnancy, in sorts and to their children after a birth).
Were not observed in female consultation during pregnancy to sorts 38 of 166 mothers (22,9 %). As a rule, women, upotrebyoljajushchie the narcotic substances abusing alcohol and having the low social status were not observed. In 6 % of cases (at 10 of 166 mothers) a HIV - the infection has been taped after sorts in various terms, at 3 mothers (1,8 %) a HIV-infection is taped at inspection concerning established a HIV-infection at the child.

Terms of revealing and establishment of the diagnosis of a HIV-infection at children sick of a tuberculosis are presented in a drawing 6.1.

Fig. 6.1. Terms of revealing and an establishment of the diagnosis of a HIV-infection at

Children sick of a tuberculosis

To 2 summer age (0-23 months) a HIV-infection it has been established in half of cases (50,1 %), approximately in peer shares at the age of 0-6 months - 18,0 %, 7-11 months-16,4 % and at the age of 12-23 months-15,7 % of cases. At the age of 2-3 years of a HIV-infection it has been established thirds by patient (29,5 %). Almost chetveryoti (20,4 %) children with a HIV-infection tuberculosis it has been established late - in 4-5 years (12,0 %) and in 6 years and is more senior (8,4 %). As a rule, at children is more senior 3th years of a HIV-infection taped under complaints and clinical implications razyolichnyh diseases.

At 2 children (1,2 %) the HIV-infection diagnosis is taken out at the age of 1,5 and 2th years then bacterination BTSZH has been spent. At both children it is taped vpoyosledstviigeneralizovannyj a tuberculosis in 3,5 years and 11 years against the serious immunodeficiency bound to a HIV-infection. In the first case the child has died in 1 month of treatment.

Later revealing of a HIV-infection at children who were ill with a tuberculosis, is bound to absence of observation in the Centers AIDS, or irregular nayobljudenija, that is explainable, considering the social status of families, where prozhivayoli these children (in more details in section - risk factors).

As half of children sick of a tuberculosis, sochetannym from a HIV - an infection, were not observed, or were observed irregularly in the Centers AIDS, early the begun antiviral therapy before disease tuberkuleyozom received only 24,1 % of patients (40 persons from 166).

Among children receiving art in a planned order (early appointment art), taped rather normal indicators of CD4-cells (table 6.1) in relation to children, not receiving art (67,5 % and 42,8 % is much more often; ОШ=2,77; Dee 1,9-4,2; p