Enhancement of Tuberculosis Detection and Prevention in HIV-Infected Patients

Abstract

Tuberculosis incidence and HIV infection incidence in the regions of the Russian Federation are declining, but the proportion of HIV positive people among the entire cohort of tuberculosis patients is clearly growing.The objective: to determine causes for increasing proportion of HIV infected people among tuberculosis patients and to provide additional recommendations for enhancement of tuberculosis detection in HIV infected patients. as well as prevention of its transmission.Subjects and Methods. The cohort of new tuberculosis patients with concurrent HIV infection (TB/HIV coinfection) in the Russian Federation region with a high prevalence of HIV infection was studied based personal medical records of patients for the first 6 months of 2022 (682 cases totally).Results. The cohort of patients with TB/HIV co-infection belonged to socially vulnerable population. Among them, the parenteral route of HIV infection transmission still prevails, while in the whole country, among new HIV patients, the sexual (heterosexual) route of transmission already prevails. The majority of patients with TB/HIV co-infection, who had been infected with HIV for more than 5 years by the time tuberculosis was detected, were not registered with the Center for AIDS Prevention and Control and accordingly received no antiretroviral therapy. In most cases, HIV-infected patients sought medical care in general medical services when they developed symptoms of tuberculosis, however they referred for help when the disease was advanced. When assessing effectiveness of tuberculosis treatment, the specific parameters of tuberculosis course in HIV-infected patients with compromised immunity have not been taken into account.