Recurrent tuberculosis among HIV-infected patients in Novokuznetsk, Russia

The aim was to examine the characteristics of recurrent tuberculosis (TB) in HIV patients. <b>Materials and Methods:</b> retrospective study of all recurrent HIV/TB cases following cure or successful treatment completion (n=153) registered in 2013 -2017 in Novokuznetsk, Russia (regional TB incidence was 83,6/100 000, HIV/TB – 48,0% of all new TB cases). HIV/TB accounted to 46,4% of all registered recurrent TB (n=330). <b>Results:</b> pulmonary TB was registered in 150 cases (98,0%). Smear and/or culture positive were 112 (74,7%), MDR was in 65 (82,3% of all drug susceptibility tests (n=79) on Löwenstein-Jensen media using absolute concentration method). Median CD4 count was 114 cells/μl (1-718 cells/μl). Antiretroviral treatment (ART) was previously initiated in 72 patients (80,2%), adherent to ART prior to TB recurrence were only 13 (18,1%), 9 (12,5%) had irregular ART, and 50 (69,4%) missed ART for at least 6 months before TB recurrence. Culture negative or susceptible TB was treated with I line drugs. MDR TB treatment received 35 patients (53,8% of all MDR), the remaining 30 (46,2%) were not assigned to MDR treatment because of DST results received after death or non-compliance. TB treatment in patients with recurrent HIV/TB was successful in 23 cases (15,1%) (10 cured and 13 treatment completed), failure was in 17 (11,1%), 77 (50,3%) died, 7 (4,6%) were transferred out, 8 (5,2%) defaulted treatment, 17 (11,1%) continued antituberculous treatment and in 4 (2,6%) TB diagnosis was withdrawn. Mortality was higher in ART defaulters (62,0%) than in those compliant to ART (23,1%) before TB recurrence (Р=0,028). <b>Conclusion:</b> recurrent HIV/TB cases had high MDR and mortality rate, the majority were noncompliant to ART.