ISSN : 2663-2187

SPECTRUM OF CLINICAL AND FUNCTIONAL IMPAIRMENTS AND LIFE LIMITATIONS IN INDIVIDUALS WITH DISABILITIES DUE TO DISEASES ASSOCIATED WITH HIV INFECTION

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Margarita Eduardovna Pakhomova, Natalya Sergeevna Zapariy, Evgeny Evgenievich Achkasov, Igor Nikolaevich Khalyastov
ยป doi: 10.33472/AFJBS.6.10.2024.5399-5421

Abstract

HIV infection stands as one of contemporary society's pressing issues. The effectiveness of rehabilitation measures and the enhancement of the quality of life for patients with HIV infection depend on the degree of clinical and functional impairments and the dynamics of their changes, leading to varying degrees of life limitations. Research Objective. Based on the study of clinical-functional, laboratory, and expert-rehabilitative characteristics of individuals with disabilities due to HIV infection necessary for conducting medical-social expertise to assess the degree of impaired body functions, the aim is to evaluate the extent of their life limitations. Materials and Methods. The study was structured in Excel tables, utilizing methods such as documentary analysis and data extraction (286 units). Statistical analysis employed mean and median for quantitative variables. For comparing two independent groups and testing the significance of research indicators, Chi-square statistics and Spearman's rank correlation coefficient were used. A significance level of 0.05 was adopted for testing statistical hypotheses. Data processing and analysis were performed using R software (a platform for statistical data analysis; https://www.r-project.org). Results: It is noted that among individuals with disabilities due to diseases associated with HIV infection, the most common clinical complaints were general weakness, fatigue, dizziness, headache, limb and joint pain, shortness of breath, weight loss, cough, and numbness. Moderate impairments in blood and immune system functions were observed in 62.7%, severe impairments in 28.4%, and significant impairments in 5.3% of cases. Neuromuscular, skeletal, and movement-related (statodynamic) functions were moderate in 10.9%, severe in 2.3%, and significantly severe in 0.3% of cases. With increasing age of individuals, sensory function impairments, cardiovascular system impairments, endocrine system and metabolism impairments, blood and immune system impairments became more severe. As the disease stage increased, severe impairments in blood and immune system functions also increased. With increasing disease severity and disability, the level of CD4+ lymphocytes and CD8+ lymphocytes increased. There was a moderate positive correlation between the level of CD4+ lymphocytes and impaired blood and immune system functions. The most characteristic limitations were in the ability for self-care, mobility, and first-degree occupational activities. As the disease stage and disability severity increased, the proportion of life limitations increased. There was a direct correlation between respiratory function impairment and total impairments, and limitation of mobility. Conclusion: Expert-rehabilitative diagnosis of individuals of various age groups with disabilities due to HIV infection, who underwent examination at the Medical and Social Expertise Bureau, contributes to the formulation of an individual and necessary volume of rehabilitation measures. Conducting expert-rehabilitative and medical-social diagnostics of this group of individuals aids in forecasting the scope of examinations, disease progression, and utilization of aspects of medical-sanitary and rehabilitation assistance.

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