Extrapulmonary Tuberculosis and HIV-Infection in Two Epidemic Regions

Abstract

Introduction: The role of extrapulmonary tuberculosis (EPTB) is under-estimated. Material and Methods: To estimate a spectrum of EPTB in two epidemic regions (Siberia, Russian Federation, and Republic Tajikistan) in accordance with human immunodeficiency virus (HIV) comorbidity, age and sex statistical reports for 2018 were analyzed. Results: In Siberia most common form was bone and joints tuberculosis (BJTB) - 43.6%, followed by urogenital tuberculosis (UGTB) – 21.3%, and tuberculosis of central nervous system (CNS-TB) -17.0%. In Tajikistan leading localization was BJTB (46.0%), followed by tuberculosis of peripheral lymph nodes (LN TB) – 27.7%. The percentage of UGTB in Tajikistan was 6.1%. In Tajikistan HIV-infected EPTB patients there were 3.5%, and in Siberia – 36.8%. CNS-TB was predominating localization in HIV-infected EPTB patients in Siberia (38.3%). In Tajikistan LN TB and BJTB (accordingly 37.9% and 31.0%) were most common for co-morbid HIV+EPTB patients. UGTB was rarest form among co-morbid patients in both regions.In Tajikistan female patients predominated among CNS-TB (71.4%), LN TB (81.5%), and abdominal tuberculosis (68.9%). In Siberia CNS-TB twice more often was found in men (67.9%), as well as BJTB: 62.9% male patients and 37.1% female patients. UGTB equally often affected men and women in both regions. Conclusions: HIV-comorbidity significantly changes the spectrum of EPTB. Spectrum of EPTB is different even in neighboring regions. Sex-age curves have unexplained tendencies. Funding Statement: There was not any grant for this study. Declaration of Interests: Authors declare that they have no conflict of interest concerning an article. Ethics Approval Statement: This study was approved by the Ethic Committee of Novosibirsk Research TB Institute as a quality assurance activity. All data were secondary, so written informed consent was not necessary for this study.