Characteristics of tuberculosis running with HIV-infection

Aim. To analyse social, clinical, x-ray and immunological features of tuberculosis (TB) in 117 patients from the Moscow region with concurrent HIV-infection. Material and methods. The patients were divided into 3 groups depending on the time of TB and HIV-infection detection in relation to each other. Group 1 patients (20.5%) had suffered from TB for 2 years before detection of HIV-infection, group 2 patients (51%) were diagnosed simultaneously for 1-2 years to have both diseases, group 3 patients (28%) had suffered from HI V-infection for 2 years before the diagnosis of TB. Results. It was established that the course of TB with associated HIV-infection depends not only on severity of immunodeficiency caused by HIV but also on characteristics of M.tuberculosis and social status of the patients. Most of TB/HIV patients were drug addicts, alcoholicts, convicts. Unfavourable social status in the above patients, contact with TB (70%) and its realization in a penitentiary carry a high risk of drug-resistant TB. High prevalence of destructive TB forms (64%), among them large caverns were in 77%, may result from M. tuberculosis resistance to antituberculous drugs and unfavourable social status of the patients. Reduction of the number of CD4-cells lowers the ability to form caverns and fibrosis and promotes dissemination of M. tuberculosis bacteria with formation of inflammation foci in different organs and systems. Conclusion. Four clinical models of TB/HIV onset and course are suggested.