FEATURES OF IMMUNOPATHOGENESIS AND EVALUATION OF CLINICAL-IMMUNOLOGICAL EFFICACY OF ANTIRETROVIRAL THERAPY IN HIV-ASSOCIATED PATIENTS WITHOUT AND WITH TUBERCULOUS LYMPHADENOPATHY

Objective: To study the immunopathogenesis of HIV infection in patients with tuberculosis without lymphadenopathy, and to develop a strategy for early diagnosis and effective treatment. Materials and Methods: Clinical and immunological studies were conducted in 94 patients, who were divided into 2 groups of 47 people, depending on the stage of HIV infection. In turn, both groups were divided into subgroups: 22 patients with tuberculous lymphadenopathy, 25 - with HIV infection without tuberculous lymphadenopathy. The control group consisted of 21 practically healthy people. Results: In HIV infection, immune status disorders are more pronounced in patients with HIV + lymphadenopathy in combination with tuberculosis. HIV infection is accompanied not only by decrease in the number of T-lymphocytes, but also by their functional insufficiency. In HIV-infected individuals, the function of Th1-producing IFN-γ was disrupted at the IV stage of the disease and, consequently, the content of NK cells enhancing antibody formation was reduced. Conclusions: At laboratory study, HIV-infected individuals should undergo a clinical blood test with an expanded leukocyte formula. When formulating a clinical blood test, priority should be given to leukocytes and the first group of cells belonging to them, lymphocytes, since these protective cells are the first to suffer from infection with HIV