Objective — to determine the frequency of small residual changes (SRC) and large residual changes (LRC), as well as the super large residual changes (SLRC) recommended by us after treatment of pulmo-nary tuberculosis (TB) and extrapulmonary localization organs with multi and extended resistance in HIV-positive patients, depending on the speed of diagnosis of TB and timely adequate antimycobacterial therapy (AMBT) with antiretroviral therapy (ART).Materials and methods. The clinical study involved 44 adult HIV-positive patients with multidrug-resistant TB (MDRTB) of lungs and extrapulmonary localization and those with localized TB with extensively drug-resistance (XDR TB), who were examined and treated (AMBT with ART) in accordance with national methods and standards. After treatment of TB, patients are distributed according to eight indicators into two identical groups of 22 people, depending on the simultaneous use of molecular genetic and cultural methods (group I) compared to using only cultural methods (group II).Results and discussion. The frequency of SRC and LRC in patients of group I was established in 9.0 and 23.0 % of cases, respectively, in patients of group II — in 23.0 and 41.0 %, the difference between the groups was not significant (p > 0.05). The frequency of malfunctions in patients of group I was detected in 52.0 % of cases, in patients of group II — in 36.0 % (p < 0.05). Significantly, high level of SLRC in HIV-positive patients with cured MDRTB and XDRTB with multiple injuries was obtained due to early diagnosis of TB and adequate AMBT, especially miliary TB and TB of the nervous system. A clinical case illustrates the results.Conclusions. In HIV-positive patients, after curing lung MDRTB/XDRTB in combination with organ extrapulmonary localization, it is recommended to additionally isolate SLRC, which include SRC and LRC of the lungs and extrapulmonary localization organs. Their high frequency is significantly affected by the rapid diagnosis of TB with the determination of a test for the sensitivity of Mycobacterium tuberculosis (MBT) to anti-TB drugs (PTP) and adequate AMBT against ART. Regarding SRC and LRC, they are equally common in HIV-positive patients after treatment of lung MDRTB/XDRTB or extrapulmonary localization, such as peripheral lymph nodes.