VARIABILITY OF HIV-ASSOCIATED TB IN THE EXAMPLE OF TUBERCULOMA BRAIN
In the presented case, the pathomorphosis of tuberculosis in HIV infection is demonstrated under the influence of various factors: biological, medical and social as a result of irregular administration of drugs and addictive behavior of the patient. In medical and social observation, it was noted that the patient refused to take art, as a result of which immunological and virological clinical and laboratory data confirmed the progression of HIV infection with a decrease in CD4 lymphocytes and an increase in viral load. Furthermore the non-adaptive behavior of the patient in the form of alcohol consumption is not allowed to conduct compliance monitoring of the intake of anti-TB drugs in the outpatient setting. In pathomorphological observation, the progression of tuberculosis against the background of HIV infection was noted. In the lungs bilateral localization of pathological formations was noted. Was determined macroscopically demarcated lesions with cavities of destruction and miliary nodules. Microscopically were found cases no signs of productive inflammation. Tuberculosis of the right hemisphere of the cerebellum led to the expressed edema and swelling of the brain with a dislocation of the trunk, which was the direct cause of death of the patient. Hematogenous dissemination and progression of tuberculosis with brain damage in co-infection with HIV/TB against the background of the start of art can be considered as an inflammatory syndrome of restoration of the immune system with "paradoxical" tuberculosis.