The article presents the review of 59 publications describing the aspects of etiology, pathogenesis, diagnostics, and treatment of COVID-19 caused by SARS-CoV-2 coronavirus.The authors state that they have no conflict of interests.
Национальный медицинский исследовательский центр фтизиопульмонологии и инфекционных заболеваний МЗ РФ, Москва, Россия Противотуберкулезная химиотерапия является основным компонентом терапии и предполагает длительное применение оптимальной комбинации лекарственных препаратов. Высокая заболеваемость туберкулезом отмечается в группах риска (лица, получающие иммуносупрессивную терапию, лица, живущие с ВИЧ, и т. д.), такие пациенты, помимо противотуберкулезной химиотерапии, получают лечение по основному заболеванию. Одновременное использование в схемах лечения большого количества препаратов может снижать приверженность к лечению пациента, ухудшать переносимость препаратов и увеличивать частоту нежелательных побочных реакций. Одним из путей снижения полипрагмазии является использование в схемах лечения препаратов пролонгированного действия. Одним из них является рифапентин, рекомендованный в РФ для терапии латентной туберкулезной инфекции у пациентов с ВИЧ-инфекцией. В обзоре представлены сведения об эффективности, о переносимости и безопасности применения препарата рифапентин в схемах лечения активной и латентной туберкулезной инфекции.
The objective: to evaluate clinical and laboratory parameters in local and generalized forms of Kaposi sarcoma (KS) in HIV infected patients to detect predictors of generalized forms of the disease.Subjects and methods. Case histories of 58 HIV infected patients with KS at the age from 28 to 80 years old were respectively analyzed; they all received treatment in National Medical Research Center of Phthisiopulmonology and Infectious Diseases of the Russian Ministry of Health in 2018-2020. Cases were divided into 2 groups depending on KS manifestations. LF group (local form of KS, n = 28) included the patients with skin lesions; GF group (generalized form of KS, n = 30) included patients with skin lesions and one or several lesions in the other sites: the mucous membrane of gastrointestinal tract, the mucous membrane of tracheobronchial tree, and lung parenchyma.Results. Patients with the generalized form of KS had a higher frequency of skin lesions on the body (pχ2 = 0.036), face (pχ2 = 0.033), and multiple sites (pχ2 = 0.018). Patients from both groups had low CD4+ count, but it was more severe in GF group (pχ2 = 0.027) with a significant increase of the viral load (pχ2 = 0.047). The predictors of the generalized form of KS are the following: the presence of specific lesions on the skin of body, face and multiple localizations, CD4 level below 125 cells/mcL, increase in the viral load above 5.3log10 copies/ml, reduction of erythrocytes level below 3.1 × 1012 cells/L. Among 24 patients with KS who had 4-6 predictors, 19 (79.2%) had the generalized form. Among KS patients with not a single predictor, there were no cases of generalized form, as well as there were no cases of local forms among patients who had 5 and 6 predictors.
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