The aim: to analyze the cases of mycobacteriosis in the population of people living with HIV, identified in the infectious diseases hospital in Saint-Petersburg over the past decade.Materials and methods. 90 cases of patients with HIV and mycobacteriosis, who were treated at the clinical infectious diseases hospital named after S.P.Botkin in the period from 2005 to 2017 were analyzed. Distribution of cases by year and etiology was performed. The inclusion criteria were the presence of HIV, culturally confirmed diagnosis of mycobacteriosis. Exclusion criteria: detection of non-tuberculosis mycobacteria without species identification. Two groups were distinguished: mycobacteriosis caused by mycobacterium avium (83 patients) and mycobacteriosis caused by other non-tuberculosis mycobacteria (7 cases). The distribution of patients by sex, age, aspects of epidemiological anamnesis was performed, the main clinical forms were characterized. Sources of bacterial excretion in mycobacteriosis in patients with HIV infection were recorded.Results. Since 2012, there has been an increase in the frequency of mycobacteriosis detection in patients with HIV: the growth of nosology over the past five years, on average, was 57% per year. Group Mycobacterium avium complex was characterized mainly by sexual path of HIV transmission (68,7%), the average age was 35 years, one third of patients were employed at the time of detection of the disease (35%). 11 persons (13,3 per cent) reported a history of being in prison, only four (4,8 per cent) were active drug users. In the group of patients with mycobacteriosis caused by other non-tuberculosis mycobacteria, the hemocontact pathway of HIV transmission prevailed (57,1%), the penitentiary history was 28,6%. In more than half of the cases, the leading source of bacterial excretion was the material of the upper respiratory tract.Conclusion. There is a steady increase in mycobacteriosis in the structure of secondary infections in patients with HIV. The leading etiological agent was mycobacterium avium, patients with this pathology has preserved social status, sexually transmitted infection. Mainly developed generalized forms of the process, the most frequent source of bacterial excretion according to this sample was the material of the respiratory tract.

Over the past decade, in Russian Federation there has been a steady increase in the incidence of MAC-infection in patients with HIV (the growth of nosology over the past five years, on average, was 57% per year). This determines the interest in this problem, especially in terms of the high inefficiency of treatment for the disease, the long term and cost of treatment. The history of the study of Mycobacterium Avium Complex-infection (MAC) originates in the early eighties in the United States, when the prognosis for a patient with AIDS and mycobacteriosis was extremely poor: mortality within one year after the detection of pathogen reached 71%. The role of infection in the thanatogenesis of patients was, however, established only by the beginning of the nineties. The detection of macrolide activity against the pathogen significantly improved the prognosis for patients, especially in combination with highly active antiretroviral therapy. The widespread introduction of antiviral drugs into practice and the ability to achieve immune reconstitution prevented the development of opportunistic infections, but did not solve the remaining issues of the treatment of the MAC-infection. The main one is the treatment of patients with a clarithromycin-resistant pathogen. There is no consensus on the sensitivity of non-tuberculous mycobacteria to antibacterials.

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