IMMUNODIAGNOSTICS HISTORICAL ASPECTS AND ITS PLACE IN THE DIAGNOSIS OF TUBERCULOSIS IN MODERN CONDITIONS AGAINST THE BACKGROUND OF HIV INFECTION IN THE POPULATION P. 32-36
E.A. Borodulina, A.V. Kalinkin, В.E. Borodulin
Samara State Medical University, Department of Tuberculosis and Pulmonology, Samara, Russia
Goal. Rate possibility of immunodiagnostics using the Mantoux skin test, «prick test», Diaskintest for their use in the diagnosis of pulmonary tuberculosis in patients with HIV infection.
Methods. Formed two groups of newly diagnosed TB patients: 134 patients with HIV infection — the main group (TB/HIV) and 100 patients without HIV infection — the comparison group (TB). Immunodiagnostics included Mantoux test with 2 TE, skin «prick test» with a 100% solution of PPD-L, Diaskintest.
Results. In the group of TB/HIV positive reaction to the Mantoux test with 2 TE was significantly less (56.0%) than in the TB group (89.0%), OR=6.4; p<0,001, the diagnostic value decreased with decreasing levels of CD4+ lymphocytes. «Prick test» had a full correlation with the results of Mantoux test, having advantages in the methods and quality of productions samples. Sensitivity tests Diaskintest in TB/HIV group was 48.3%, in the TB group – 84.6%, while the sensitivity expressed Diaskintest immunodeficiency dropped from 80% to 17%.
Conclusions: immunodiagnostics in patients with HIV-infection informative at the level of CD4+ lymphocytes 300 cells/mm or more; for the formation of high-risk groups, followed by testing for tuberculosis may be used technique prick test.
Keywords: tuberculosis, HIV-infection, immunodiagnostics, Mantoux test, skin prick test, Diaskintest.