The objective of the study: to identify the specific parameters of hepatotoxic reactions in tuberculosis patients depending on the presence of hepatitis B and C markers in the blood. Subjects and methods. The state of the hepatobiliary system was studied in 107 HIV-negative patients with newly diagnosed infiltrative pulmonary tuberculosis in the destructive phase. The main group included 52 people with positive results of the tests for markers of viral hepatitis B and C, the comparison group included 55 people with negative results. The groups were compatible in age, volume of the lung tissue lesions, and drug resistance profile. Results. Even before the start of anti-tuberculosis therapy, in the main group had elevated levels of cholinesterase and blood amylase, ultrasound examination detected hyperechoic liver parenchyma, enlarged right lobe of the liver, liver veins fibrosis, the enlarged diameter of the cystic duct and splenic vein, and splenomegaly (p <0.05), which was statistically significantly more frequent than in the comparison group. In the course of treatment, patients of both groups developed hepatotoxic reactions, however, in the main group they were more frequent versus the comparison group (88.4 and 21.8%, respectively, p <0.05), appeared earlier on average by 14 days and were accompanied by more pronounced clinical manifestations and abnormalities of biochemical parameters.

The result of analysis of the tuberculosis morbidity of military servicemen in 2009-2015 is presented. The most significant risk factors and the contribution of risk group in the morbidity in modern conditions are established. Quality of the dispensary observation of risk group is estimated, the principal defects are revealed. The paths for the further improvement of anti-tuberculosis measures in the Armed Forces of the Russian Federation are offered: carrying out the immunodiagnostics of tuberculosis at citizens before the beginning of military service and profound medical examination of all young army reinforcement

The analysis of the features of diagnostics of peripheral lymph nodes tuberculosis in modern conditions is carried out. For this 28 case histories of patients suffering from tuberculosis of peripheral lymph nodes were studied and 85,7% of them had a combination of tuberculosis and infection caused by the human immunodeficiency virus. All patients were undergoing biopsies or surgery of lymph nodes, and the material was examined using microbiological molecular, genetic and histological methods. 85,7% of patients had relapses with different periods of time, on average, 34 years, and repeated periods of tuberculosis activation. At all patients the lymph nodes were enlarged, mainly cervical (71,4%) and axillary (67,9%), the sizes of nodes varied from 1 to 5 cm, on average, 2,21,6 cm. In 78,6% cases tuberculosis of peripheral lymph nodes was characterized by fluctuation of nodes and the discharge of 30 to 80 ml of odorless creamy pus. It was found that tuberculosis of peripheral lymph nodes is part of a widespread tuberculous lesions especially at patients with tuberculosis associated with an infection caused by the human immunodeficiency virus. Tuberculosis of peripheral lymph nodes develops simultaneously with a specific lesion of other groups of lymph nodes intrathoracic (75%), intra-abdominal (57,1%), which allows to generalized tuberculosis of the lymphatic system. Fibrobronchoscopy showed in 35,7% patients residual bronchial tuberculosis changes, at 14,3% an active fistulous form of bronchial tuberculosis. Microscopy of biopsy material was negative at 78,6% of cases, while cultural examination revealed Mycobacterium tuberculosis in 100% and molecular genetic studies deoxyribonucleic acid of Mycobacterium tuberculosis in 64,3% patients.