MARKERS OF PROTEIN-ENERGY MALNUTRITION IN TUBERCULOSIS PATIENTS WITH CONCURRENT HIV INFECTION DURING TREATMENT

224 tuberculosis cases with concurrent HIV infection were examined. Nutritional status was defined based on the body mass index (BMI), levels of transthyretin, albumin and total protein in the blood serum. It was found out that tuberculosis patients with concurrent HIV infection had a severe nutritional deficiency, which was confirmed by the confident reduction of BMI, transthyretin and albumin levels in blood serum. Whereby, the intensity of protein and energy deficiency in tuberculosis patients with concurrent HIV infection was associated on the one hand with the specific course of tuberculosis and on the other hand with the course of HIV infection. The most significant reduction of nutritional status was observed in the patients with fibrous cavernous tuberculosis, multiple localizations of tuberculosis, dissemination of tuberculous lesions in more than two lobes, lung tissue destruction and bacillary excretion and extensive drug resistance. It was found out that the most severe protein-energy deficiency was detected if the CD4 count was below 0.35 x 109/L and viral load exceeded 500,000 copies/ml. The dynamic follow-up showed that the effective treatment provided a significant improvement of protein-energy deficiency. Despite it, even in 6 months of treatment, there was no complete recovery of nutritional status. Should the treatment fail, protein-energy deficiency deteriorated, which was proved by the reduction of BMI, transthyretin, albumin and total protein levels.