Non-invasive diagnosis and treatment of patients with HIV infection, tuberculosis, and chronic hepatitis C

Objective: to assess the efficacy of treatment in HIV-infected patients using liver elastometry and to evaluate severity of hepatic fibrosis using instrumental methods before and after specific treatment. Materials and methods. This study included 56 patients with tuberculosis (TB), HIV-coinfection (stage 4B-4C), and liver lesions, who were followed up in the TB dispensary and AIDS center of Saratov between January 2017 and October 2018. All study participants were diagnosed with hepatitis C. We used enzyme-linked immunosorbent assay (detection of antibodies against hepatitis C virus) and polymerase chain reaction (detection of viral RNA) to confirm the diagnosis. Each patient was informed about the use of the blood for standard testing and signed an informed consent. Conclusion. Patients receiving both antiretroviral and antituberculosis therapy were twice as likely to have stage F3 and F4 hepatic fibrosis (cirrhosis) than those with lower drug load. The specificity of ultrasound examination was 72.3% for the detection of chronic hepatitis, which suggests the need for a comprehensive examination, in particular, the implementation of liver elastometry for patients with echographic changes in the liver in order to assess the severity of hepatic fibrosis.