Introduction: The article presents an analysis of the state of the immune system of HIV-infected patients with tuberculosis, the rate of recurrence of tuberculosis in HIV-infected people against the background of insufficient preventive therapy against HIV-infection and tuberculosis. Aim: To assess the effect of clinical aspects of the course of combined pathology (HIV infection and tuberculosis) on the spread of isolation of bacteria of tuberculosis mycobacteria as one of the main risk factors for infection in foci. Materials and methods: comparative analysis of isolation of bacteria of tuberculosis mycobacteria among patients with combined pathology (tuberculosis and HIV) was carried out (main group): determination of CD4 lymphocyte cell number and isolation of tuberculosis mycobacteria (n = 100). The number of TB recurrences in the main group (100 patients) and comparison group (TB patients) – 100 patients were studied. Data processing was carried out using the calculation of intensive and extensive indicators, the calculation of the standard error of the average (m). Statistical analysis was performed using Microsoft Excel. The results testified: the impact of the clinical course in tuberculosis patients with HIV infection characterized by an immunodeficiency condition, the presence of stages of 4B and 4V HIV infection (65,0 (95% RI:55;74)) and the recurrent course of tuberculosis in 25% (95 RI:17,5;34) is 1.4 times higher than in tuberculosis and is one of the main risk factors for infection in foci.