The objective: analysis of clinical cases of tuberculous spondylitis in HIV-infected patients with the detection of HIV RNA in the focus of vertebral bodies destruction.Subjects and Methods. Medical records of 2 HIV-infected patients who underwent surgery for verified tuberculous spondylitis were analyzed. Parts of the vertebral bodies collected during surgery were examined (PCR, microbiological and histological tests), those were parts with destruction and fragments of healthy iliac bone necessary to fill the implant during corporodesis.Results. M. tuberculosis RNA was detected in the foci of bone destructionas as well as M. tuberculosis DNA. The viral load in the fragments of healthy iliac bone and peripheral blood of these patients was undetectable.

The objective: to study the changes in the lung microbiota in inbred C57BL/6 mice after aerogenic infection with M. tuberculosis in an experimental tuberculosis model.Subjects and Methods. This study was carried out on 20 female mice of inbred line C57BL/6 weighing 20-22 grams which were infected in a Glas-Col aerosol chamber (USA) with the culture of M. tuberculosis of virulent strain H37Rv at the dose of 400 CFU/lung. Morphological and microbiological assessment of the lungs state was performed before (day 0) (n=5) and 7 (n=5), 30 (n=5) and 60 (n=5) days after the infection. The results obtained were subjected to statistical processing using ANOVA test and Student t-test.Results. 7, 30, and 60 days after aerosol infection with M. tuberculosis against the background of successive morphological and microbiological changes typical of the experimental tuberculosis model, we established an imbalance of bacterial population in the lung microbiota. Before infection with M. tuberculosis, a scanty biotope was recorded with a predominance of lactobacilli –Lactobacillus murinus, Lactobacillus apodeme. 7, 30 and 60 days after infection with M. tuberculosis, consistent changes were recorded, such as increase in the number and diversity of the bacterial population. The most indicative markers of the recorded imbalance were: Streptococcus thoraltensis, Streptococcus acidominiminus, Arthrobacter crystallopoietes, Staphylococcus hominis, Micrococcus luteus.Conclusion. Tuberculosis infection is a significant factor affecting the state of the lung microbiota. With increased duration of the infection with M. tuberculosis, imbalance of the bacterial flora is formed in the lungs of C57BL/6 mice, accompanied by characteristic tissue inflammation and growing mycobacterial load.

The objective: to develop the procedure for etiological diagnosis of infectious coxitis (IC) depending on the patient's HIV status.Subjects and Methods. The data of medical records of 97 patients with signs of IC were analyzed. Patients were divided into group depending on their HIV status.Results. The time required to diagnose IC was identified, and it made 7.35 ± 1.30 months for HIV-positive patients, and 6.25 ± 0.90 months for HIV negative patients (p > 0.05). The procedure was developed to be implemented when a patient complained of pain in the hip joint. Patients with HIV infection and suspected IC should undergo computed tomography (CT) of the hip joints, and HIV-negative patients should have CT done if the hip joint X-ray is not informative. The use of CT in the HIV+ Group reduced the diagnostic time from 9.4 ± 1.3 to 5.3 ± 1.3 months (p = 0.680), in the HIV- Group – from 8.7 ± 1.2 to 3.8 ± 0.6 months (p = 0.02). The reason why diagnosis took that long was the rare use of invasive methods at the outpatient stage. Thus, puncture of the hip joint was performed in the HIV+ Group in 2.7% of cases, in the HIV- Group – in 10%. Trepanobiopsy performed in a hospital made it possible to establish the etiology of IC in all patients. The diagnostic efficacy of microbiological tests in case of tuberculous coxitis made 48.64% in the HIV+ Group and 30.0% in the HIV- Group, in case of nonspecific coxitis it was 32.43% and 30.0%, respectively.