Medical and social portrait of a newly diagnosed tuberculosis patient with HIV infection in the Tomsk region

The aim. To identify the medical and social features of respiratory tuberculosis in newly diagnosed patients in combination with HIV infection. Materials and methods. For the analysis, information was used on 1,234 newly diagnosed patients with verified respiratory tuberculosis with or without HIV infection during two follow-up periods (from January 2017 to March 2019 and from November 2019 to December 2021). Objectives of the study. To conduct a dynamic analysis of clinical and epidemiological data of patients with newly diagnosed respiratory tuberculosis and HIV infection; to determine the level of multiple drug resistance of MBT to anti-tuberculosis drugs. Results and discussion. A newly diagnosed patient with HIV-associated tuberculosis living in an area with a high prevalence of HIV (Tomsk region) is mainly an urban resident, a young man aged 18–40 years, with an HIV infection history of 3 or more years, not registered for HIV in a quarter of cases, and with severe immunodeficiency in 60% of cases. During the observation period, the proportion of patients with a CD4 lymphocyte level below 200 cells/ml increases (53.3% and 60.9%, respectively, p=0.07), and as a pathogenetic result of severe immunodeficiency, the proportion of patients with disseminated pulmonary tuberculosis increases proportionally (49.8% and 63.8%, respectively, p=0.001); primary multiple drug resistance of the pathogen reaches a frequency of occurrence of 43.1% in TB/HIV, and 23.8% in patients without HIV infection (p<0.001). Conclusion. First identified tuberculosis in HIV-infected patients in the region with high prevalence of HIV (Tomsk region) is characterised by an advanced severe course with a high frequency of MDR MBT without dynamic improvement.