Severe pneumonia in HIV/COVID-19 co-infection (case study)

The COVID-19 pandemic has turned the lives of all people in society upside down, changing almost all aspects of everyday life, and therefore the discussion of the problem of CO-infection with HIV and COVID-19 in this clinical case is necessary and extremely relevant for doctors. The interaction of HIV and SARS-CoV-2, pathogenetic features, clinical manifestations of co-infection remain a relevant topic for modern research and observations. It should be noted that these two viruses have a significant impact on the human immune system, and this fact is promising for the development of clinical guidelines for the provision of medical care to HIV-infected patients with COVID-19. This article presents a clinical case of severe pneumonia in HIV/COVID-19 co-infection that demonstrates the difficulty in treating such patients. An HIV-infected patient of stage 4B who has refused ART, as well as vaccination against a new coronavirus infection, becomes ill with COVID-19. Against the background of the protracted course of COVID-19, there was a progression of HIV infection with the development of severe bilateralpneumocystis pneumonia and Kaposi's sarcoma. Low adherence to self-control in a patient with HIV infection was emphasized. The use of inadequate ART regimens and, subsequently, the rejection of it, the lack of advisory support regarding adherence to therapy, lead tosuccessful attempts to achieve virological control over HIV infection, as well as to prevent the progression of severe respiratory failure. The effect on the accession of pneumocystis pneumonia with the development of such a complication as acute respiratory distress syndrome has been demonstrated. It was established that coronavirus infection in this case could play the role of a trigger in the development of pneumocystis pneumonia in an immunosuppressive patient with HIV infection.The issues of modern methods of laboratory examination and treatment of infections of the lower respiratory tract are discussed – the most common recurrent infections, including HIV/AIDS, threatening the patient's life.

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