Possibilities of endoscopic diagnosis of opportunistic infections in patients with HIV/tuberculosis co-infection

Aim of the study : To establish the incidence of opportunistic infections (OI) in patients with HIV/tuberculosis co-infection depending on the severity of immunosuppression and to evaluate the role of endoscopy in the diagnosis of concomitant diseases. Materials and methods : A retrospective analysis was performed of the inpatient medical records of 170 patients with HIV/tuberculosis co-infection in 2023 who underwent diagnostic bronchoscopy and esophagogastroduodenoscopy with sampling for the diagnosis of OI. Results : The spectrum and frequency of occurrence of concomitant OIs, except for tuberculosis, were as follows:esophageal candidiasis in 37 patients (21.8%), CMV infection in 24 patients (14.2%), Pneumocystis pneumonia in 6 patients (3.6%), mycobacteriosis in 4 patients (2.4%), Kaposi's sarcoma in 4 patients (2.4%), and CNS toxoplasmosis in 2 patients (1.2%). The sensitivity and specificity of endoscopic biopsy for the diagnosis of esophageal candidiasis was 100%; Pneumocystis pneumonia and pulmonary mycobacteriosis were verified in 100% of cases using bronchoalveolar lavage. A comparative analysis of the frequency of secondary infectious lesions depending on the form of pulmonary tuberculosis showed that patients with disseminated tuberculosis were more often diagnosed with esophageal candidiasis (36.1% of cases, p=0.005), while patients with disseminated tuberculosis and caseous pneumonia were significantly more likely to have manifest CMV infection (13.9% and 50%, respectively, p=0.006).An analysis of the incidence of concomitant diseases in patients with different numbers of CD4 lymphocytes in the blood showed a significant predominance of esophageal candidiasis (p