Comorbidity: pulmonary tuberculosis and chronic obstructive pulmonary disease

<b>Purpose:</b> The proportion of patients with pulmonary tuberculosis complicated by comorbidity that affects the course and outcomes of tuberculosis increases. To assess the presence and degree of aggravating effect of the chronic obstructive pulmonary disease (COPD) on the course of tuberculosis and its outcome <b>Material and Methods:</b> Multivariate prospective study was performed in the group of 2831 patients with pulmonary tuberculosis aged 18-79 who were evaluated at the Outpatient Department of the CTRI between 2016-2017. Patient evaluation included clinical, biochemical, immunological, microbiological and respiratory function tests, ECG, radiography, chest CT and bronchoscopy. <b>Results:</b> Concomitant pathology in TB patients was reported in 45.1 % of cases. Most frequently tuberculosis was accompanied by COPD - in 18.7% of cases (529 people). Of which, 47.5% (251 people) had broncho-obstructive syndrome accompanied by bronchiectasis. The analysis of clinical forms of tuberculosis in patients with COPD showed the predominance of severe, disseminated, chronic processes - cirrhotic and fibrous-cavernous forms of the disease (35.8% and 30.4%, respectively). The mean age of these patients was 52.1±3.2 years. Focal and infiltrative tuberculosis was observed only in 8.1% of patients with the mean age of 29.2±2.6 years. <b>Conclusions:</b> COPD has an aggravating effect on the course of tuberculosis, contributes to the development of severe chronic forms of the disease, which complicates treatment of patients. In the presence of COPD in patients with pulmonary tuberculosis, therapy adjustment is required to improve the effectiveness of TB treatment.