TY - JOUR T1 - Diagnostic of pleural effusion in HIV-positive patients JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2019.PA1086 VL - 54 IS - suppl 63 SP - PA1086 AU - Mikhail Sinitsyn AU - Tamila Abu Arqoub AU - Boris Barsky AU - Dmitrii Plotkin AU - Mikhail Reshetnikov Y1 - 2019/09/28 UR - http://erj.ersjournals.com/content/54/suppl_63/PA1086.abstract N2 - Patients with HIV infection are more likely to develop tuberculosis. Tuberculosis pleurisy is quite common in patients with HIV infection.The purpose of this study was to improve the diagnostic of pleural effusion in HIV - positive patients.42 HIV-positive patients with pleurisy of unknown etiology were examined.Used radiological methods were informative for suspicion of tuberculosis in 66.6% of patients, since these patients had changes in lungs. After diagnostic pleural aspiration, acid-fact bacterium, mycobacterium DNA were not detected in pleural fluid.The activity of adenosine deaminase (ADA) in the effusion, often did not exceed the reference values, and its activity was high only in 3 patients (7.1%). In all 42 patients while thoracoscopy, there was effusion on the side of the lesion in a volume from 1000 to 2000 ml with multiple septum and a cellular structure, and tubercular tumor-like lesions on the parietal pleura were found in (35; 83.3%) patients. In all cases, a target biopsy of pleura was performed, more than 25 altered areas, and the partition walls were destroyed, and the contents were evacuated. Histological examination of serous membranes visualized accumulations of caseous necrosis without the formation of “classical” granulomas (14; 33.3%), in 27 (64.2%) cases the formation of classical granulomas was noted. When acid -fast stain was done - acid-resistant bacteria in biopsy specimens were determined in 30 cases (71.4%). DNA of tuberculous mycobacterium in altered pleura was found in 39 patients (92.8%), of which 10 patients (23.8%) showed resistance to rifampicin.Conclusion: it is possible to consider thoracoscopy with biopsy as the only reliable method for diagnosing tuberculous pleurisy.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA1086.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -