Reasons for the increase in post-mortal detection of tuberculosis combined with HIV infection in a region with high prevalence of these diseases and approaches to assessing the effectiveness of anti-tuberculosis care provided to HIV patients

The incidence rate of tuberculosis in the Russian Federation in 2022 was 31.3 per 100 thousand people. At the same time, in some regions this figure exceeds the average for the Russian Federation by 2 times or more. Analysis of the epidemiological situation of HIV infection shows a relationship between the prevalence of HIV infection in the regions and the incidence rate of tuberculosis, the proportion of HIV-infected patients among newly diagnosed cases of tuberculosis and HIV-infected patients among patients who died during the year with a diagnosis of tuberculosis.

The aim. To study the contingent of patients with tuberculosis combined with HIV infection in a region with a high prevalence of HIV infection, to determine the causes of death of patients with tuberculosis combined with HIV infection within a year after its detection and posthumous diagnosis, to determine the correctness of the criteria for assessing anti-tuberculosis care in conditions of high prevalence of HIV infection.

Materials and methods. In a region with a high prevalence of HIV infection, all cases of tuberculosis combined with HIV infection were studied from February to October 2023 (148). A separate analysis of data on deceased patients was conducted (the main and immediate cause of death, the presence of other secondary HIV infections were studied). Results and discussion. The contingent of patients with tuberculosis combined with HIV infection in the region in all main categories remains the same as in previous years in the Russian Federation (except for age). In all cases, the cause of death of patients with tuberculosis, both posthumously and within a year after its detection, was very rapid progression in the late stages of HIV infection. In 19.0% of cases, tuberculosis could not be considered the cause of death, since, despite the presence of generalized tuberculosis, other secondary diseases were simultaneously present, equally influencing the outcome.

Conclusion. Considering all of the above and taking into account that in the Russian Federation more than a quarter of tuberculosis patients have HIV infection, the criteria for assessing the work of the TB service with HIV patients should be defined separately. A separate reporting form should be created to analyze statistical data on cases of tuberculosis combined with HIV infection.

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