Detection of mycobacterium tuberculosis in sputum of patients with HIV infection using a modern algorithm of etiological diagnosis of disease

Zimina, V.N.; Микова, О. Е.; Varetskaya, T. A.; Oborin, Denis A.; Degtyareva, Svetlana; Sergevnin, V. I.; Aids, Controlling

doi:10.20953/1729-9225-2018-1-28-34

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“…Необходимо упомянуть о диагностике туберкулеза у больных ВИЧ-инфекцией, которая, безусловно, базируется на классических критериях постановки диагноза, однако имеет свои особенности [23][24][25]. Определение возбудителя микробиологическими методами или его ДНК молекулярногенетическими -основополагающий диагностический критерий [26,27]. Однако бактериовыделение у инфицированных ВИЧ больных туберкулезом встречается реже ввиду нетипичности протекания туберкулеза на фоне иммуносупрессии и, соответственно, отсутствия полостей распада в легочной ткани, лимфогематогенного распространения МБТ с формированием внелегочных локализаций туберкулеза или генерализации заболевания.…”

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The treatment of tuberculosis under current conditions

Sinitsyn

Калинина

Belilovskiy

et al. 2020

Terapevticheskii arkhiv

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Aim. Study of the current state of problems of treatment of patients with tuberculosis based on literature data and their own experience. Materials and methods. In the Russian Federation, the number and proportion of patients with co-infection with HIV/tuberculosis continues to increase against the background of improvement in the main epidemiological indicants for tuberculosis. In 2017, 20.9% of newly diagnosed tuberculosis patients had HIV infection. The combination of the two infections significantly complicates the further improvement of the situation with tuberculosis, and the appearance of drug-resistant strains of Mycobacterium tuberculosis sometimes completely neutralizes the results of chemotherapy. The article describes the schemes of modern tuberculosis chemotherapy taking into account HIV/tuberculosis co-infection, as well as MDR in combination with surgical treatment methods, as well as analyzes the data of epidemiological monitoring of treatment of 1115 tuberculosis patients newly diagnosed in 2017 in Moscow, 360 tuberculosis patients with MDR MBT (cohort 20132014), the results of treatment with the use of new chemotherapy regimens for tuberculosis (bedaquiline, linezolid, moxifloxacin) in 36 patients, the effectiveness and safety of surgical methods in 192 patients. Results. The application of new individualized anti-TB chemotherapy schedules in patients with HIV co-infection/tuberculosis with MDR-MBT has allowed to improve the treatment efficacy. The surgical intervention combined with modern chemotherapy regimens in patients with HIV/tuberculosis co-infection with MDR MBT has been proved to be effective and safe, contributes to the improving the results of treatment for this category of patients. Conclusion. The confluence of two global problems of co-infection HIV/TB and MDR TB, significantly prevents from the end of the tuberculosis epidemic in the world. At the same time, advances in the development and implementation of new anti-TB drugs and surgical treatment methods give hope for significant progress for resolving this situation.

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