Clinical features of patients with the diagnosis of tuberculous spondylitis in combination with HIV and hepatitis C

clinically characterize patients with tuberculous spondylitis, HIV and hepatitis C and bacteriologically characterize the causative agent of tuberculous spondylitis. Tuberculous spondylitis is a specific infectious lesion of the spine caused by Mycobacterium tuberculosis complex. This form of extrapulmonary tuberculosis more often develops in patients with an immune system deficiency due to HIV. Due to the peculiarities of tuberculous spondylitis, it is often impossible to obtain information about drug resistance of the pathogen even when examining bone resectates. 418 samples of bone material from 333 patients diagnosed with tuberculous spondylitis were examined. 96 cultures of Mycobacterium tuberculosis were obtained and their drug sensitivity was determined. Phenotypic testing of drug resistance was carried out using proportion method on solid/liquid nutrient media. In 291 samples, mycobacterial DNA was sufficient to detect mutations. Patients diagnosed with tuberculous spondylitis and co-infection with HIV and hepatitis C, compared with the group without co-infection, were characterized by a longer duration of hospitalization (164±11.3 days and 131±17.25 days, respectively, p<0.05), a higher frequency of re-hospitalizations (2.16 ±0.13 and 1.8±0.2, p<0.05) and spinal surgeries (1.8±0.12 and 1.4±0.21, p<0.05), as well as multifocal defeats. Patients with co-infection are characterized by a wider spectrum of drug resistance of the pathogen (Fig. 1), the predominance of the Beijing genotype (94.1%), including the highly contagious Beijing B0\W148 line (36.3%). Based on these data, these patients should be considered at risk for MDR/XDR tuberculosis even in the absence of data on the drug susceptibility of the pathogen.