pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2024-34-6-822-831pulmo-4614Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESОсобенности течения хронической обструктивной болезни легких у пациентов с туберкулезом легких и ВИЧ-инфекциейClinical features of chronic obstructive pulmonary disease in patients with pulmonary tuberculosis and HIV infectionhttps://orcid.org/0009-0008-1034-3724ТлаисХ.TlaisH.

Тлаис Хади – аспирант кафедры пульмонологии факультета дополнительного профессионального образования Института непрерывного образования и профессионального развития.

117997, Москва, ул. Островитянова, 1; тел.: (495) 965-45-20

Hadi Tlais - Postgraduate Student, Department of Pulmonology, Faculty of Continuing Professional Education, Institute of Continuous Education and Professional Development.

Ul. Ostrovityanova 1, Moscow, 117997; tel.: (495) 965-45-20

tlais88@mail.ruhttps://orcid.org/0000-0003-3672-9242АнаевЭ. Х.AnaevE. Kh.

Анаев Эльдар Хусеевич – д. м. н., профессор кафедры факультета дополнительного профессионального образования Института непрерывного образования и профессионального развития.

117997, Москва, ул. Островитянова, 1; тел.: (495) 965-45-20

Eldar Kh. Anaev - Doctor of Medicine, Professor, Department of the Faculty of Continuing Professional Education, Institute of Continuous Education and Professional Development.

Ul. Ostrovityanova 1, Moscow, 117997; tel.: (495)965-45-20

el_anaev@hotmail.comhttps://orcid.org/0000-0002-1562-6386КняжескаяН. П.KniajeskaiaN. P.

Княжеская Надежда Павловна – к. м. н., доцент, заведующая учебной частью кафедры пульмонологии факультета дополнительного профессионального образования Института непрерывного образования и профессионального развития.

117997, Москва, ул. Островитянова, 1; тел.: (499) 780-08-43

Nadezhda P. Kniajeskaia - Candidate of Medicine, Head of the Academic Department of the Pulmonology Department, Faculty of Continuing Professional Education, Institute of Continuous Education and Professional Development.

Ul. Ostrovityanova 1, Moscow, 117997; tel.: (499) 780-08-43

kniajeskaia@mail.ruhttps://orcid.org/0000-0003-3292-8949ЩелыкалинаС. П.ShchelykalinaS. P.

Щелыкалина Светлана Павловна – к. м. н., доцент, доцент кафедры медицинской кибернетики и информатики имени С.А. Гаспаряна Медико-биологического факультета.

117997, Москва, ул. Островитянова, 1; тел.: (495) 434-54-78

Svetlana P. Shchelykalina - Candidate of Medicine, Associate Professor, Assistant Professor, S.A. Gasparyan Department of Medical Cybernetics and Informatics, Medical and Biological Faculty.

Ul. Ostrovityanova 1, Moscow, 117997; tel.: (495) 434-54-78

svetlanath@inbox.ruhttps://orcid.org/0000-0001-6050-724XБелевскийА. С.BelevskiyA. S.

Белевский Андрей Станиславович – д. м. н., профессор, заведующий кафедрой пульмонологии факультета дополнительного профессионального образования Института непрерывного образования и профессионального развития.

117997, Москва, ул. Островитянова, 1; тел.: (495) 965-09-27

Andrey S. Belevskiy - Doctor of Medicine, Professor, Head of the Department of Pulmonology, Faculty of Continuing Professional Education, Institute of Continuous Education and Professional Development.

Ul. Ostrovityanova 1, Moscow, 117997; tel.: (495) 965-09-27

pulmobas@yandex.ruФедеральное государственное автономное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Министерства здравоохранения Российской ФедерацииРоссияFederal State Autonomous Educational Institution of Higher Education “N.I. Pirogov Russian National Research Medical University” of the Ministry of Health of the Russian FederationRussian Federation202411122024346822831Copyright © Тлаис Х., Анаев Э.Х., Княжеская Н.П., Щелыкалина С.П., Белевский А.С., 20242024Тлаис Х., Анаев Э.Х., Княжеская Н.П., Щелыкалина С.П., Белевский А.С.Tlais H., Anaev E.K., Kniajeskaia N.P., Shchelykalina S.P., Belevskiy A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/4614

Целью исследования являлось проведение сравнительной оценки клинико-функциональных и лабораторных показателей у пациентов с хронической обструктивной болезнью легких (ХОБЛ) и туберкулезом легких (ТЛ) с ВИЧ-инфекцией и без таковой.

Материалы и методы

Материалы и методы. Обследованы пациенты с ХОБЛ и ТЛ (n = 160 (80 – с ВИЧ-инфекцией, 80 – без ВИЧ-инфекции); возраст – 40–65 лет). Пациенты были госпитализированы в Санкт-Петербургское Государственное бюджетное учреждение здравоохранения «Городской противотуберкулезный диспансер» (Санкт-Петербург). Проводились оценка клинических симптомов по модифицированной шкале Британского медицинского исследовательского совета для оценки тяжести одышки (modified Medical Research Council Dyspnea Scale – mMRC) и оценочному тесту ХОБЛ (COPD Assessment Test™ – CAT), лабораторных показателей, степени вирусной нагрузки (количество копий вируса и СD4-клеток в 1 мл крови и в процентах от числа лимфоцитов), исследование легочной функции.

Результаты

Результаты. У всех обследованных ХОБЛ характеризовалась тяжелым течением (≥ 2 обострений в год). Курили в настоящее время и в прошлом > 90 % больных. ВИЧ-позитивные пациенты с ХОБЛ и ТЛ были моложе ВИЧ-негативных лиц (44 (41; 48) года vs 53 (45; 63) года; p < 0,001). Индекс массы тела у ВИЧ-негативных пациентов был выше (22,15 (19,85; 25,13) кг / м2 vs 21,2 (19,3; 22,95) кг / м2; p = 0,050). По содержанию CD4-клеток ВИЧ-позитивные пациенты с низкой вирусной нагрузкой (≤ 40 копий / мл) статистически значимо отличались от ВИЧ-позитивных с высокой вирусной нагрузкой (> 40 копий / мл) (p < 0,001). Более выраженная одышка отмечена у пациентов с «молодой» (не старше 50 лет) и «старой» (старше 50 лет) ХОБЛ с ТЛ и ВИЧ-инфекцией по сравнению с ВИЧ-негативными лицами (p < 0,001). Симптомы ХОБЛ по САТ были более выражены у ВИЧ-позитивных пациентов (p < 0,001) с ХОБЛ в возрасте до 50 лет и старше 50 лет, причем у ВИЧ-позитивных пациентов по сравнению с ВИЧ-негативными лицами сумма баллов при оценке по САТ была выше (p < 0,05). Степень тяжести ХОБЛ по критериям Глобальной инициативы по хронической обструктивной болезни легких (Global Initiative for Chronic Obstructive Lung Disease – GOLD) была значимо выше у пациентов и с «молодой», и со «старой» ХОБЛ и ВИЧинфекцией по сравнению с ВИЧ-негативными (p < 0,05).

Заключение

Заключение. У пациентов с ХОБЛ, ТЛ и ВИЧ-инфекцией по сравнению с пациентами без ВИЧ-инфекции установлены снижение массы тела, более выраженная одышка и симптомы ХОБЛ, обструктивные нарушения легочной вентиляции.

Aim

Aim. To conduct a comparative assessment of clinical, functional and laboratory parameters in patients with COPD and pulmonary tuberculosis with and without HIV infection.

Methods

Methods. 160 patients with COPD and pulmonary tuberculosis were examined, including 80 with HIV infection and 80 without HIV infection. The patients were hospitalized in the State Budgetary Healthcare Institution “City Anti-Tuberculosis Dispensary” (Saint Petersburg). The clinical symptoms (shortness of breath according to the mMRC, CAT), laboratory parameters, the viral load (the number of virus copies and CD4 cells in 1 ml of blood and as a percentage of lymphocytes) and the lung function were assessed.

Results

Results. All examined patients had severe COPD with 2 or more exacerbations per year. More than 90% of the patients were current or former smokers. The HIV-positive patients with COPD and tuberculosis were younger than the HIV-negative (the mean age was 44 (41; 48) years versus 53 (45; 63) years, p < 0.001). The body mass index in the HIV-negative patients was higher than in the HIV-positive (22.15 (19.85; 25.13) kg/m2 vs 21.2 (19.3; 22.95) kg/m2, p = 0.050). The HIV-positive patients with low viral load (40 copies/ml and below) statistically significantly differed from the HIV-positive patients with high viral load (above 40 copies/ml) in the CD4 cell count (p < 0.001). Both the “younger” (aged 50 years or less) and “older” (aged over 50 years) HIV-positive patients with COPD and tuberculosis had more severe dyspnea compared to the HIV-negative patients (p < 0.001). COPD symptoms according to the CAT test were more severe in both “younger” and “older” HIV-positive patients (p < 0.001), and the score was higher in the HIV-positive patients compared to the HIV-negative patients (p < 0.05). The severity of COPD according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria was significantly higher in both “younger” and “older” HIV-positive patients compared to the HIVnegative patients (p < 0.05).

Conclusion

Conclusion. Patients with COPD, tuberculosis, and HIV infection have decreased body weight, more pronounced dyspnea and symptoms of COPD and obstructive pulmonary ventilation disorders compared to the patients without HIV infection.

хроническая обструктивная болезнь легкихтуберкулез легкихВИЧ-инфекциявирусная нагрузкаchronic obstructive pulmonary diseasepulmonary tuberculosisHIV infectionviral loadСпонсорская поддержка исследования отсутствовалаThe study was not sponsoredReferencesVenkatesan P. GOLD report: 2022 update. Lancet Respir. Med. 2022; 10 (2): e20. DOI: 10.1016/S2213-2600(21)00561-0.Venkatesan P. GOLD report: 2022 update. Lancet Respir. Med. 2022; 10 (2): e20. DOI: 10.1016/S2213-2600(21)00561-0.World Health Organization. World health statistics 2015. Geneva: WHO Press; 2023. Available at: https://www.who.int/publications/i/item/9789240694439World Health Organization. World health statistics 2015. Geneva: WHO Press; 2023. Available at: https://www.who.int/publications/i/item/9789240694439Çolak Y., Afzal S., Nordestgaard B.G. et al. Prevalence, characteristics, and prognosis of early chronic obstructive pulmonary disease. The Copenhagen General Population Study. Am. J. Respir. Crit. Care Med. 2020; 201 (6): 671–680. DOI: 10.1164/rccm.201908-1644OC.Çolak Y., Afzal S., Nordestgaard B.G. et al. Prevalence, characteristics, and prognosis of early chronic obstructive pulmonary disease. The Copenhagen General Population Study. Am. J. Respir. Crit. Care Med. 2020; 201 (6): 671–680. DOI: 10.1164/rccm.201908-1644OC.Byanova K., Kunisaki K.M., Vasquez J., Huang L. Chronic obstructive pulmonary disease in HIV. Expert Rev. Respir. Med. 2021; 15 (1): 71–87. DOI: 10.1080/17476348.2021.1848556.Byanova K., Kunisaki K.M., Vasquez J., Huang L. Chronic obstructive pulmonary disease in HIV. Expert Rev. Respir. Med. 2021; 15 (1): 71–87. DOI: 10.1080/17476348.2021.1848556.Kamenar K., Hossen S., Gupte A.N. et al. Previous tuberculosis disease as a risk factor for chronic obstructive pulmonary disease: a cross-sectional analysis of multicountry, population-based studies. Thorax. 2021; 77 (11): 1088–1097. DOI: 10.1136/thoraxjnl-2020-216500.Kamenar K., Hossen S., Gupte A.N. et al. Previous tuberculosis disease as a risk factor for chronic obstructive pulmonary disease: a cross-sectional analysis of multicountry, population-based studies. Thorax. 2021; 77 (11): 1088–1097. DOI: 10.1136/thoraxjnl-2020-216500.UNAIDS. Global HIV. AIDS statistics – Fact sheet 2023. Available at: https://reliefweb.int/report/world/global-hiv-aids-statistics-fact-sheet-2023 [Accessed: February 23, 2019].UNAIDS. Global HIV. AIDS statistics – Fact sheet 2023. Available at: https://reliefweb.int/report/world/global-hiv-aids-statistics-fact-sheet-2023 [Accessed: February 23, 2019].Bagcchi S. WHO’s global tuberculosis report 2022. Lancet Microbe. 2023; 4 (1): e20. DOI: 10.1016/S2666-5247(22)00359-7.Bagcchi S. WHO’s global tuberculosis report 2022. Lancet Microbe. 2023; 4 (1): e20. DOI: 10.1016/S2666-5247(22)00359-7.Makinson A., Hayot M., Eymard-Duvernay S. et al. HIV is associated with airway obstruction: a matched controlled study. AIDS. 2018; 32 (2): 227–232. DOI: 10.1097/QAD.0000000000001691.Makinson A., Hayot M., Eymard-Duvernay S. et al. HIV is associated with airway obstruction: a matched controlled study. AIDS. 2018; 32 (2): 227–232. DOI: 10.1097/QAD.0000000000001691.Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease: 2024 Report. Available at: https://goldcopd.org/2024-gold-report/Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease: 2024 Report. Available at: https://goldcopd.org/2024-gold-report/Singhvi D., Bon J., Morris A. Obstructive lung disease in HIV-phenotypes and pathogenesis. Curr. HIV/AIDS Rep. 2019; 16 (4): 359–369. DOI: 10.1007/s11904-019-00456-3.Singhvi D., Bon J., Morris A. Obstructive lung disease in HIV-phenotypes and pathogenesis. Curr. HIV/AIDS Rep. 2019; 16 (4): 359–369. DOI: 10.1007/s11904-019-00456-3.Konstantinidis I., Crothers K., Kunisaki K.M. et al. HIV-associated lung disease. Nat. Rev. Dis. Primers. 2023; 9 (1): 39. DOI: 10.1038/s41572-023-00450-5.Konstantinidis I., Crothers K., Kunisaki K.M. et al. HIV-associated lung disease. Nat. Rev. Dis. Primers. 2023; 9 (1): 39. DOI: 10.1038/s41572-023-00450-5.Diaz P.T., King M.A., Pakht A. et al. Increased susceptibility to emphysema among HIV-seropositive smokers. Ann. Intern. Med. 2000; 132 (2): 369–372. DOI: 10.7326/0003-4819-132-5-200003070-00006.Diaz P.T., King M.A., Pakht A. et al. Increased susceptibility to emphysema among HIV-seropositive smokers. Ann. Intern. Med. 2000; 132 (2): 369–372. DOI: 10.7326/0003-4819-132-5-200003070-00006.Pérez-Padilla R. Would widespread availability of spirometry solve the problem of underdiagnosis of COPD. Int. J. Tuberc. Lung Dis. 2016; 20 (1): 4. DOI: 10.5588/ijtld.15.0893.Pérez-Padilla R. Would widespread availability of spirometry solve the problem of underdiagnosis of COPD. Int. J. Tuberc. Lung Dis. 2016; 20 (1): 4. DOI: 10.5588/ijtld.15.0893.Maitre T., Cottenet J., Beltramo G. et al. Increasing burden of noninfectious lung disease in persons living with HIV: a 7-year study using the French nationwide hospital administrative database. Eur. Respir. J. 2018; 52 (3): 1800359. DOI: 10.1183/13993003.00359-2018.Maitre T., Cottenet J., Beltramo G. et al. Increasing burden of noninfectious lung disease in persons living with HIV: a 7-year study using the French nationwide hospital administrative database. Eur. Respir. J. 2018; 52 (3): 1800359. DOI: 10.1183/13993003.00359-2018.Martinez F.J., Han M.K., Allinson J.P. et al. At the root: defning and halting progression of early chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2018; 197 (12): 1540–1551. DOI: 10.1164/rccm.201710-2028PP.Martinez F.J., Han M.K., Allinson J.P. et al. At the root: defning and halting progression of early chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2018; 197 (12): 1540–1551. DOI: 10.1164/rccm.201710-2028PP.Agustí A., Noell G., Brugada J., Faner R. Lung function in early adulthood and health in later life: a transgenerational cohort analysis. Lancet Respir. Med. 2017; 5 (12): 935–945. DOI: 10.1016/S2213-2600(17)30434-4.Agustí A., Noell G., Brugada J., Faner R. Lung function in early adulthood and health in later life: a transgenerational cohort analysis. Lancet Respir. Med. 2017; 5 (12): 935–945. DOI: 10.1016/S2213-2600(17)30434-4.Lambert A.A., Kirk G.D., Astemborski J. et al. HIV infection is associated with an increased risk of exacerbation of COPD. J. Acquir. Immune Defic. Syndr. 2019; 69 (1): 68–74. DOI: 10.1097/QAI.0000000000000552.Lambert A.A., Kirk G.D., Astemborski J. et al. HIV infection is associated with an increased risk of exacerbation of COPD. J. Acquir. Immune Defic. Syndr. 2019; 69 (1): 68–74. DOI: 10.1097/QAI.0000000000000552.Siddharthan T., Grigsby M., Morgan B. et al. Prevalence of chronic respiratory disease in urban and rural Uganda. Bull. World Health Organ. 2019; 97 (5): 318–327. DOI: 10.2471/BLT.18.216523.Siddharthan T., Grigsby M., Morgan B. et al. Prevalence of chronic respiratory disease in urban and rural Uganda. Bull. World Health Organ. 2019; 97 (5): 318–327. DOI: 10.2471/BLT.18.216523.Kayongo A., Wosu A.C., Naz T. et al. Chronic obstructive pulmonary disease prevalence and associated factors in a setting of well-controlled HIV, a cross-sectional study. COPD. 2020; 17 (3): 297–305. DOI: 10.1080/15412555.2020.1769583.Kayongo A., Wosu A.C., Naz T. et al. Chronic obstructive pulmonary disease prevalence and associated factors in a setting of well-controlled HIV, a cross-sectional study. COPD. 2020; 17 (3): 297–305. DOI: 10.1080/15412555.2020.1769583.Brown J., Roy A., Harris R. et al. Respiratory symptoms in people living with HIV and the effect of antiretroviral therapy: a systematic review and meta-analysis. Thorax. 2017; 72 (4): 355–366. DOI: 10.1136/thoraxjnl-2016-208657.Brown J., Roy A., Harris R. et al. Respiratory symptoms in people living with HIV and the effect of antiretroviral therapy: a systematic review and meta-analysis. Thorax. 2017; 72 (4): 355–366. DOI: 10.1136/thoraxjnl-2016-208657.Triplette M., Attia E., Akgun K. et al. The differential impact of emphysema on respiratory symptoms and 6-minute walk distance in HIV infection. J. Acquir. Immune Defic. Syndr. 2017; 74 (1): e23–29. DOI: 10.1097/QAI.0000000000001133.Triplette M., Attia E., Akgun K. et al. The differential impact of emphysema on respiratory symptoms and 6-minute walk distance in HIV infection. J. Acquir. Immune Defic. Syndr. 2017; 74 (1): e23–29. DOI: 10.1097/QAI.0000000000001133.De la Rosa Carrillo D., Olveira C., García-Clemente M. et al. COPD assessment test in bronchiectasis: minimum clinically important difference and psychometric validation: a prospective study. Chest. 2020; 157 (4): 824–833. DOI: 10.1016/j.chest.2019.08.1916.De la Rosa Carrillo D., Olveira C., García-Clemente M. et al. COPD assessment test in bronchiectasis: minimum clinically important difference and psychometric validation: a prospective study. Chest. 2020; 157 (4): 824–833. DOI: 10.1016/j.chest.2019.08.1916.Jones P.W., Brusselle G., Dal Negro R.W. et al. Properties of the COPD assessment test in a cross-sectional European study. Eur. Respir. J. 2011; 38 (1): 29–35. DOI: 10.1183/09031936.00177210.Jones P.W., Brusselle G., Dal Negro R.W. et al. Properties of the COPD assessment test in a cross-sectional European study. Eur. Respir. J. 2011; 38 (1): 29–35. DOI: 10.1183/09031936.00177210.Кравец С.Л., Ханин А.Л. Хроническая обструктивная болезнь легких у пациентов с легочным туберкулезом. В кн.: Медицина XXI века: сборник VI научно-практической конференции молодых ученых. Новокузнецк; 2016: 60–62.Kravets S.L., Khanin A.L. [Chronic obstructive pulmonary disease in patients with pulmonary tuberculosis]. In: [Medicine of the XXI century: digest of the VI scientific and practical conference of young scientists]. Novokuznetsk; 2016: 60–62 (in Russian).Depp T.B., McGinnis K.A., Kremer K. et al. Risk factors associated with acute exacerbation of chronic obstructive pulmonary disease in HIV-infected and uninfected patients. AIDS. 2016; 30 (3): 455–463. DOI: 10.1097/QAD.0000000000000940.Depp T.B., McGinnis K.A., Kremer K. et al. Risk factors associated with acute exacerbation of chronic obstructive pulmonary disease in HIV-infected and uninfected patients. AIDS. 2016; 30 (3): 455–463. DOI: 10.1097/QAD.0000000000000940.Ronit A., Lundgren J., Afzal S. et al. Airflow limitation in people living with HIV and matched uninfected controls. Thorax. 2018; 73 (5): 431–438. DOI: 10.1136/thoraxjnl-2017-211079.Ronit A., Lundgren J., Afzal S. et al. Airflow limitation in people living with HIV and matched uninfected controls. Thorax. 2018; 73 (5): 431–438. DOI: 10.1136/thoraxjnl-2017-211079.Drummond M.B., Kirk G.D. HIV-associated obstructive lung diseases: insights and implications for the clinician. Lancet Respir. Med. 2014; 2 (7): 583–592. DOI: 10.1016/S2213-2600(14)70017-7.Drummond M.B., Kirk G.D. HIV-associated obstructive lung diseases: insights and implications for the clinician. Lancet Respir. Med. 2014; 2 (7): 583–592. DOI: 10.1016/S2213-2600(14)70017-7.Gingo M.R., Morris A., Crothers K. Human immunodeficiency virus-associated obstructive lung diseases. Clin. Chest Med. 2013; 34 (2): 273–282. DOI: 10.1016/j.ccm.2013.02.002.Gingo M.R., Morris A., Crothers K. Human immunodeficiency virus-associated obstructive lung diseases. Clin. Chest Med. 2013; 34 (2): 273–282. DOI: 10.1016/j.ccm.2013.02.002.Di Stefano A., Dossena F., Gnemmi I. et al. Decreased humoral immune response in the bronchi of rapid decliners with chronic obstructive pulmonary disease. Respir. Res. 2022; 23 (1): 200. DOI: 10.1186/s12931-022-02125-3.Di Stefano A., Dossena F., Gnemmi I. et al. Decreased humoral immune response in the bronchi of rapid decliners with chronic obstructive pulmonary disease. Respir. Res. 2022; 23 (1): 200. DOI: 10.1186/s12931-022-02125-3.Чучалин А.Г., Цеймах И.Я., Момот А.П. и др. Изменения системных воспалительных и гемостатических реакций у больных с обострением хронической обструктивной болезни легких с сопутствующими хронической сердечной недостаточностью и ожирением. Пульмонология. 2014; (6): 25–32. DOI: 10.18093/0869-0189-2014-0-6-25-32.Chuchalin A.G., Tseymakh I.Ya., Momot A.P. et al. [Changes in systemic inflammatory and hemostatic response in patients with co-morbidity of exacerbation of chronic obstructive pulmonary disease, chronic heart failure and obesity]. Pul'monologiya. 2014; (6): 25–32. DOI: 10.18093/0869-0189-2014-0-6-25-32 (in Russian).Auld S.C., Kornfeld H., Maenetje P. et al. Pulmonary restriction predicts long-term pulmonary impairment in people with HIV and tuberculosis. BMC Pulm. Med. 2021; 21 (1): 19. DOI: 10.1186/s12890-020-01368-4.Auld S.C., Kornfeld H., Maenetje P. et al. Pulmonary restriction predicts long-term pulmonary impairment in people with HIV and tuberculosis. BMC Pulm. Med. 2021; 21 (1): 19. DOI: 10.1186/s12890-020-01368-4.Ханин А.Л., Кравец С.Л. Хроническая обструктивная болезнь легких и туберкулез: актуальная проблема в реальной практике (обзор литературы). Вестник современной клинической медицины. 2017 (6): 60–70. DOI: 10.20969/vskm.2017.10(6).60-70.Khanin AL, Kravets SL. [Chronic obstructive pulmonary disease and tuberculosis: the latest problem in real clinical practice (review)]. 2017; 10 (6): 60–70. DOI: 10.20969/vskm.2017.10(6).60-70 (in Russian).Singhvi D., Bon J., Morris A. Obstructive lung disease in HIV-phenotypes and pathogenesis. Curr. HIV/AIDS Rep. 2019; 16 (4): 359–369. DOI: 10.1007/s11904-019-00456-3.Singhvi D., Bon J., Morris A. Obstructive lung disease in HIV-phenotypes and pathogenesis. Curr. HIV/AIDS Rep. 2019; 16 (4): 359–369. DOI: 10.1007/s11904-019-00456-3.Chimukangara B., Lessells R.J., Rhee S.Y. et al. Trends in pretreatment HIV-1 drug resistance in antiretroviral therapy-naive adults in South Africa, 2000–2016: a pooled sequence analysis. EClinicalMedicine. 2019; 9: 26–34. DOI: 10.1016/j.eclinm.2019.03.006.Chimukangara B., Lessells R.J., Rhee S.Y. et al. Trends in pretreatment HIV-1 drug resistance in antiretroviral therapy-naive adults in South Africa, 2000–2016: a pooled sequence analysis. EClinicalMedicine. 2019; 9: 26–34. DOI: 10.1016/j.eclinm.2019.03.006.Triplett M., Attia E.F., Akgyun K.M. et al. A low CD4/CD8 ratio in peripheral blood is associated with pulmonary emphysema in HIV. PLoS One. 2017; 12 (1): e0170857. DOI: 10.1371/journal.pone.0170857.Triplett M., Attia E.F., Akgyun K.M. et al. A low CD4/CD8 ratio in peripheral blood is associated with pulmonary emphysema in HIV. PLoS One. 2017; 12 (1): e0170857. DOI: 10.1371/journal.pone.0170857.Collier D.A., Monit C., Gupta R.K. The impact of HIV-1 drug escape on the global treatment landscape. Cell Host Microbe. 2019; 26 (1): 48–60. DOI: 10.1016/j.chom.2019.06.010.Collier D.A., Monit C., Gupta R.K. The impact of HIV-1 drug escape on the global treatment landscape. Cell Host Microbe. 2019; 26 (1): 48–60. DOI: 10.1016/j.chom.2019.06.010.Drain P.K., Dorward J., Violette L.R. et al. Point-of-care HIV viral load testing combined with task shifting to improve treatment outcomes (STREAM): findings from an open-label, non-inferiority, randomised controlled trial. Lancet HIV. 2020; 7 (4): e229–237. DOI: 10.1016/S2352-3018(19)30402-3.Drain P.K., Dorward J., Violette L.R. et al. Point-of-care HIV viral load testing combined with task shifting to improve treatment outcomes (STREAM): findings from an open-label, non-inferiority, randomised controlled trial. Lancet HIV. 2020; 7 (4): e229–237. DOI: 10.1016/S2352-3018(19)30402-3.Sadiq U., Shrestha U., Guzman N. Prevention of opportunistic infections in HIV/AIDS. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available at: https://www.ncbi.nlm.nih.gov/books/NBK513345/Sadiq U., Shrestha U., Guzman N. Prevention of opportunistic infections in HIV/AIDS. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available at: https://www.ncbi.nlm.nih.gov/books/NBK513345/Nacher M., Huber F., Adriouch L. et al. Temporal trend of the proportion of patients presenting with advanced HIV in French Guiana: stuck on the asymptote? BMC Res. Notes. 2018; 11 (1): 831. DOI: 10.1186/s13104-018-3944-y.Nacher M., Huber F., Adriouch L. et al. Temporal trend of the proportion of patients presenting with advanced HIV in French Guiana: stuck on the asymptote? BMC Res. Notes. 2018; 11 (1): 831. DOI: 10.1186/s13104-018-3944-y.

The authors declare that there are no conflicts of interest present.