S.V. KHALIULLINA¹, V.A. ANOKHIN¹, Yu.S. SOLUYANOVA², K.R. KHALIULLINA¹, G.V. GALINA¹, Kh.S. KHAYERTYNOV¹, T.A. AGLYAMOVA³

¹Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan

²Republic Center for the Prevention and Control of AIDS and ID, Kazan

³Naberezhnye Chelny Infectious Hospital, Naberezhnye Chelny

 Contact:

Khaliullina S.V. ― MD, Associate Professor of the Department of Pediatric Infections

Address: 49 Butlerov Str., Kazan, Russian Federation, 420012, tel. (843) 267-80-06, e-mail: svekhal@mail.ru

Objective ― to evaluate etiological and clinical features of infectious endocarditis (IE) in HIV-infected intravenous drug users (IDUs) for timely diagnosis and adequate treatment.

Material and methods. We analyzed medical records of 26 HIV-infected IDUs hospitalized in the Infectious Diseases Hospital with a diagnosis of IE from January to December 2016. The disease history has been monitored to date. The average age of the patients was 35.9 y.o.; 95% CI 26.2-45.6 years, duration of HIV infection ― 10.3 years; 95% CI 0.6-20 years. The 2B stage of HIV infection was diagnosed in one patient, the latent (3) stage in 5, 4A in 11, 4B in 8 and 4B in one patient. The study design is observational retrospective.

Results. A subacute course of IE was recorded in 22 patients, acute in three, recurring in one patient. 89-100% of patients complained of fever, weakness, lack of appetite and other signs of intoxication upon admission. Respiratory failure was recorded in 40% of patients, lymphadenopathy ― in 45%, hepatosplenomegaly ― in 96%, and small Duke criteria ― in 18%. In 8 patients, IE proceeded in isolation, in 14 – as one of the foci of septic process. Isolated lesions of the tricuspid valve in IDUs were diagnosed in 15 patients, mitral in 5, tricuspid and aortic in 4. S. aureus was identified in the blood of 84.6% of the examined. In one case, C. albicans and S. epidermidis were identified. Cephalosporins of generation 3, carbapenems, fluoroquinolones and vancomycin were usually used to treat IE in IDUs. Mortality was 11.5%.

Conclusion. IE in HIV-infected IDUs in most cases occurs with damages of the right sections of heart, due to S. aureus and is combined with severe polysegmental pneumonia. There were no specific clinical markers of IE in this group of patients, and fever was the most common complaint.

Key words: infective endocarditis, intravenous drug users, HIV Infection, adults.

(For citation: Khaliullina S.V., Anokhin V.A., Soluyanova Yu.S., Khaliullina K.R., Galina G.V., Khayertynov Kh.S., Aglyamova T.A. Infective endocarditis in HIV-infected intravenous drug users. Practical medicine. 2020. Vol. 18, №1, P. 88-92)

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