Author/Editor		Vidmar, Ludvik; Matičič, Mojca; Tomažič, Janez; Klavs, Irena; Poljak, Mario
Title		Tuberkuloza pri bolnikih z aidsom v Sloveniji
Translated title		Tuberculosis in patients with aids in Slovenia
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 66, št. 5
Publication year		1997
Volume		str. 245-7
Language		slo
Abstract		Background. The emergence of aids has strongly influence the existing epidemiology of tuberculosis. HIV infection may complicate the management of coexisting tuberculosis and tuberculosis itself may accelerate the course of HIV disease. In Slovenia, aids epidemics is still in an early stage. It has been established that tuberculosis plays an important role in our patients with HIV infection. Methods. In a retrospective study of the period 1986 to 1996 we examined the clinical records of the patients with HIV infection and coexisting tuberculosis treated at the Department of Infectious Diseases, University Medical Centre Ljubljana, Slovenia, where all the HIV infected patients from Slovenia are hospitalised or followed up. Results. Out of 58 patients with aids 17 (29%) suffered from tuberculosis. 11 (65%) were homo/bisexual men. Twelve patients (71%) disclosed HIV infection while diagnosed tuberculosis. Five patients (29%) had tuberculin skin test positive. Diagnosis was confirmed bacteriologically in 14 cases (82%). Non-specific radiological changes were present in 4 patients (23.5%) whereas no radiologically visible changes were observed in two patients (12%). No patient died directly from tuberculosis. A multiple drug resistant M. tuberculosis has not yet been observed. Conclusions. The data available show that the occurrence of tuberculosis in a HIV infected person in Slovenia should stronly be considered. Tuberculosis is the most common case-definition diagnosis of aids in Slovenia so national guidelines on routine testing of patients with newly detected tuberculosis, aged 18 to 50 years, for HIV infection have been established in 1995 according to WHO recommendations.
Summary		Izhodišča. Pojav aidsa je močno posegel v obstoječe epidemiološko stanje tuberkuloze. Okužba z virusom HIV lahko bistveno spremeni naravni potek in učinkovitost zdravljenja tuberkuloze, prav tako pa tudi tuberkuloza lahko močno poseže v naravni potek bolezni HIV. V Sloveniji je epidemija aidsa še vedno v zgodnji fazi. Tuberkuloza ima pri nas med bolniki, okuženimi z virusom HIV, pomembno mesto. Metode. V retrospektivni študiji, ki je zajela obdobje od leta 1986 do leta 1996, smo pregledali klinične zapise vseh bolnikov, okuženih z visrusom HIV in hkrati z Mycobacterium tuberculosis, ki so bili zdravljeni na Kliniki za infekcijske bolezni in vročinska stanja v Ljubljani, kjer se vodijo in zdravijo vse osebe, okužene z virusom HIV, v Sloveniji. Rezultati. Od 58 bolnikov z aidsom jih je 17 (29%) imelo tudi tuberkulozo. 11 (65%) je bilo homoseksualnih oziroma biseksualnih moških. V 12 primerih (71%) se je pri obravnavi tuberkuloze razkrila okužba z virusom HIV. Pri 14 bolnikih (82%) je bila diagnoza potrjena bakteriološko, le 5 bolnikov (29%) pa je imelo pozitiven tuberkulinski test. Štirje bolniki (23,5%) so imeli neznačilne rentgenogramske spremembe na pljučih, dva (12%) pa sta bila popolnoma brez le-teh. Noben bolnik ni zaradi tuberkuloze umrl. Za enkrat še nismo odkrili M. tuberculosis, ki bi bila odporna na več tuberkulostatičnih zdravil. Zaključki. Podatki nakazujejo, da je v Sloveniji tuberkuloza pogosta pri osebah, okuženih z virusom HIV. Je tudi vodilna indikatorska bolezen prijavljenih primerov aidsa, zato so bila leta 1995 v skladu s priporočili Svetovne zdravstvene organizacije sprejeta navodila za rutinsko testiranje vseh bolnikov z novo odkrito tuberkulozo, starih od 18 do 50 let, na okužbo z virusom HIV.
Descriptors		AIDS-RELATED OPPORTUNISTIC INFECTIONS TUBERCULOSIS ACQUIRED IMMUNODEFICIENCY SYNDROME SLOVENIA HIV RETROSPECTIVE STUDIES ADULT CHILD