CLINICAL AND LABORATORY MARKERS OF DIGESTIVE SYSTEM DISEASES IN HIV-INFECTED PATIENTS FOR FAMILY MEDICINE PRACTICE

The aim: To identify clinical and laboratory signs of digestive system disease in HIV-infected patients for helping family physicians.

Materials and methods: Research was conducted at five regional HIV / AIDS centers in Ukraine during 2017-2019. Randomly selected 342 adult HIV-infected patients were divided into two groups, with concomitant digestive system diseases and without concomitant digestive system disease. Statistical analysis was performed using the software package EZR 1.41 (Saitama Medical Center, Jichi Medical University, Japan).

Results: The incidence of digestive system disease in patients with HIV clinical stages II, III and IV was significantly higher than in patients with HIV clinical stage I. Gastrointestinal disease was also significantly associated with the incidence of tuberculosis, candidiasis, kidney disease and HIV encephalopathy. Incidence of asthenic-vegetative and dyspeptic syndromes, weight loss, anemia and leukopenia, elevated liver enzymes, low CD4 counts and detectable viral load levels in patients on antiretroviral therapy were significantly more common in HIV-infected patients with gastrointestinal pathologies. HIV patients with digestive system disease significantly more often had changes to their therapy regiment, interruptions in treatment and more often experienced side effects.

Conclusions: Digestive system disease becomes more common with the progression of HIV infection. Comorbidity of HIV infection and digestive system disease is characterized by changes in general clinical, biochemical and immunological blood parameters and patients with digestive system comorbidities more often have a poor virological response to antiretroviral therapy.