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Chapter 2. Materials and research methods

The present work was carried out in following basic directions.

The first direction has been devoted the comparative retrospective epidemiological analysis of a tuberculosis, a HIV-infection and virus hepatitises in St.-Petersburg, a tuberculosis and VICH/SPID to an infection in Ho Chi Minh.

The analysis of epidemic process of a tuberculosis in a combination to a HIV - was spent by an infection and-or haemocontact virus hepatitises on the basic epidemiological parametres: intensity, long-term dynamics, structure, age and social groups of risk, risk factors.

The second direction consisted in carrying out of the analysis of 8426 special cards sick of a tuberculosis - mono and mikst (a tuberculosis in a combination to a HIV-infection and-or VG), written out of city antituberculous hospital № 2 of SPb. During the period with 2002 on 2005гг. The analysis included: calculation of indicators of a case rate by a tuberculosis on a sex, age and the social status, the analysis of prevalence of a HIV at sick of a tuberculosis in dynamics and depending on a floor and age of patients, studying of etiological structure, dynamics of frequency of revealing of virus hepatitises In and With among sick various units of hospital and at patients of specialised unit for sick of a tuberculosis in a combination to a HIV-infection and VG.

The third prospektivnoe the work direction included profound studying of epidemiological and clinico-laboratory data at 208 patients TB in SPb, by a principle «the Case - the control», parted on 3 groups. At 125 patients it is diagnosed TB in a combination to a HIV and VG (the basic group - OG), at 48 observed - ТБ+ВИЧ (the first group of comparison - ІГС) and for 35 persons - TB + VG (the second group - PGS). All patients have received treatment in tubercular hospital of SPb in 2005. For comparison the analysis of the same data at 56 patients TB treated in tubercular hospital of of Ho Chi Minh has been carried out. From them 32 patients TB in a combination to a HIV and VG (the basic group - OG), 25 persons — TB and VG (group
Comparisons - GS). All information on patients gathered under the uniform specially developed program. In the first section of the questionnaire by a tuberculosis, a HIV-infection and VG, statement dates on the account, stay time nameplate data, the social status, prescription of disease have been reflected in the treatment, accompanying diseases. In the second - data of the epidemiological anamnesis, a concerning tuberculosis, a HIV and VG. In the third section of the questionnaire results of clinical inspection, treatment sick of a tuberculosis and revealings at them hepatopathies in dynamics of observation are presented. The subjective data specified by the patient were considered not only objective clinico-laboratory, but also. Initial data were fixed in the questionnaire prior to the beginning of treatment, traced ezhedekadno within 6 month of observation which depended on duration of specific antituberculous therapy. The complex of laboratory researches including the general clinical analysis of blood, biochemical tests was applied to statement of the diagnosis of a hepatitis and an estimation of a functional condition of a liver: quantitative definition of the general bilirubin and its direct fraction, definition of activity of an alaninaminotranspherase, an aspartate aminotransferase, a thymol turbidity test, a fibrinogen. In the fourth section of the questionnaire bacteriological researches, and also bacterioscopic and radiological data in dynamics, applied preparations to which sensitivity of micobacteria was defined are presented special immunologic, serologicheskie.

Patients OG and comparison groups were exposed standard laboratory and to X-ray inspections. Immunologic blood analysises included definition of total of leucocytes, absolute and relative maintenance CD3 (T-limfotsitov), CD4 (T - helpers), CD8 (T-cytotoxic) lymphocytes, parity CD4/CD8 on flowing cytometer FACSCALIBUR of firm BECTON DICKINSON in laboratories of the city centre on preventive maintenance and struggle against AIDS and infectious diseases.

The comparative analysis of survey samples both in SPb, and in Ho Chi Minh was spent on epidemiological (the anamnesis, a sex, age and the social status) and to clinico-laboratory data (at entering of patients to a hospital and against treatment). On clinico-laboratory, serologicheskim and to immunologic data the indirect estimation of efficiency of treatment VG and a tuberculosis at sick of a triple infection, frequency of opportunistic infections and the complications taped at hospitalisation in hospital and in dynamics of treatment XT was carried out.

Necessity is proved and protivoyoepidemicheskih actions for the prevention of diffusion VG and a HIV - of an infection at sick of a tuberculosis and a method of a maintenance therapy the complex is developed for the given category of patients.

Statistical processing of results of research is spent on personal computer AMD Athlon HR2500 with use of programs, Microsoft Word, Microsoft Excel 2003. Average sizes of indicators () were defined and standard errors of average sizes (), reliability of differences was estimated by t-criterion Stjudenta-Fishera (differences were considered authentic at probability of 95 %, r

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A source: Le Than Toan. the EPIDEMIOLOGICAL And CLINICO-LABORATORY CHARACTERISTIC of VIRUS HEPATITISES And a HIV - INFECTIONS At SICK of the TUBERCULOSIS. The dissertation on competition of a scientific degree of the candidate of medical sciences. St.-Petersburg -. 2006

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