Русский
Risk factors for tuberculosis in patients with HIV infection
DOI: https://dx.doi.org/10.18565/epidem.2022.12.3.71-7
Kulabukhova E.I., Kravchenko A.V., Zimina V.N., Pokrovskaya A.V., Suvorova Z.K., Khokhlova O.N., Vinokurova O.O., Kadyrova A.A., Rzaeva A.M., Sarkisyants N.K., Davidyan A.S., Sergeenko S.V., Saprykina Zh.A., Bekbolotov A.A., Abdrakhmanova E.D., Volchenkov G.V., Zamkovaya T.N.., Sattorov S.S., Soliev A.A., Bekmetova M.Yu., Normuratova G.A., Pokrovsky V.V.
1) Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; 2) Peoples’ Friendship University of Russia, Moscow, Russia; 3) Research Institute of Pulmonary Diseases, Baku, Azerbaijan Republic; 4) Republican Center for AIDS Control, Baku, Azerbaijan Republic; 5) National Center for Infectious Diseases, Yerevan, Republic of Armenia; 6) National Institute of Health, Yerevan, Republic of Armenia; 7) Republican Center for Hygiene, Epidemiology, and Public Health, Minsk, Republic of Belarus; 8) Republican Research and Practical Center for Pulmonology and Phthisiology, Minsk, Republic of Belarus; 9) Republican AIDS Center, Ministry of Health, Bishkek, Kyrgyz Republic; 10) National Center for Phthisiology, Ministry of Health, Bishkek, Kyrgyz Republic; 11) Center for Specialized Phthisiopulmonological Care, Vladimir, Russia; 12) Regional Center for AIDS Prevention and Control, Regional Clinical Hospital, Vladimir, Russia; 13) Republican Center for AIDS Prevention and Control, Dushanbe, Republic of Tajikistan; 14) Republican Center for AIDS Control, Tashkent, Republic of Uzbekistan
Subjects and methods. The investigation involved 1000 patients from 7 countries: the Republic of Azerbaijan, the Republic of Armenia, Belarus, Tajikistan, Uzbekistan, the Kyrgyz Republic, and the Russian Federation (Vladimir Region (VR)), who were divided into 3 groups: 1) those with HIV/active tuberculosis (HIV/TB) coinfection (a HIV/TB group), 2) those with HIV monoinfection (a HIV group), and 3) those with active tuberculosis (a TB group). To analyze risk factors for the development of active TB, the authors analyzed data from medical records and surveyed the patients in these groups.
Results. The largest number of contacts with TB patients were seen in HIV/TB patients in the Republics of Armenia and Belarus, and VR of the Russian Federation, as well as in TB patients in the Republic of Azerbaijan, while the preventive TB treatment coverage among the HIV-infected patients varied from low (0–24%) in the Republics of Belarus and Armenia and in the VR of the Russian Federation to high (88–100%) in the other countries participating in the study. The increased TB susceptibility comorbid background (diabetes mellitus, silicosis, chronic renal failure requiring hemodialysis, and the intake of immunosuppressants) was more common in the TB group. The CD4 lymphocyte counts, both at baseline and at the time of TB diagnosis, were significantly lower in patients with HIV/TB coinfection than in those in the HIV group. The HIV/TB group had the most unfavorable socioeconomic characteristics (a low level of education, an income below subsistence level, and unemployment status). According to the region, HIV/TB and HIV patients were more likely to come to other countries to work; TB patients were less likely. The most active injecting drug use took place in the Russian Federation (VR) and the Republic of Belarus. Our attention was engaged by the high prevalence of smoking in the HIV/TB group in the Republic of Belarus (64%), the VR of the Russian Federation (68%), the Republic of Armenia (64%), and the Republic of Azerbaijan (86%).
Conclusion. The large proportion of patients with a low income, a low level of education, a history of psychoactive substance use, and labor migration in the HIV/TB group indicates the need for educational activities and the greater relevance of social support to increase adherence during both prevention and treatment of active TB.
Literature
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About the Autors
Ekaterina I. Kulabukhova, Cand. Med. Sci., Infectiologist, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Head, Laboratory, Department of Infectious Diseases with Courses in Epidemiology and Phthisiology, Medical Institute, People’s Friendship University of Russia, Moscow, Russia; ekulabukhova@mail.ru; https://orcid.org/0000-0003-3645-7275
Professor Aleksey V. Kravchenko, MD, Leading Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; alexey-kravtchenko@yandex.ru; http://orcid.org/0000-0001-7857-3763
Vera N. Zimina, MD, Professor, Department of Infectious Diseases with Courses in Epidemiology and Phthisiology, Medical Institute, People’s Friendship University of Russia, Moscow, Russia; vera-zim@yandex.ru;https://orcid.org/0000-0003-3726-9022
Anastasia V. Pokrovskaya, MD, Senior Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Associate Professor, Department of Infectious Diseases with Courses in Epidemiology and Phthisiology, Peoples’ Friendship University of Russia, Moscow, Russia; pokrovskaya_av@mail. ru; http://orcid.org/0000-0002-2677-0404
Zoya K. Suvorova, Cand. Biol. Sci., Senior Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; zksu@inbox.ru; https://orcid.org /0000-0003-4055-289X
Olga N. Khokhlova, Cand. Med. Sci., Laboratory Doctor, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; x.olia79@mail.ru; https://orcid.org/0000-0001-9736-4043
Olga O. Vinokurova, Candidate of Medical Sciences, Assistant Lecturer, Department of Infectious Diseases with Courses in Epidemiology and Phthisiology, Peoples’ Friendship University of Russia, Moscow, Russia; olga.berejnaya12@gmail.com; https://orcid.org/0000-0001-5689-7628
Professor Agigat A.-K. Kadyrova, MD, Director, Research Institute of Pulmonary Diseases, Baku, Azerbaijan Republic; dr.kadyrovah@mail.ru; https://orcid.org/0000-0001-5297-9191
Adelуa M-K. Rzaeva, Head, Admission Department, Republican Center for AIDS Control, Ministry of Health of the Azerbaijan Republic, Baku, Azerbaijan Republic; rzayeva.adela@gmail.com
Narina K. Sarkisyants, Cand. Medi. Sci., Deputy Director for Science and Development, National Center for Infectious Diseases; Head, Department of Infectious Diseases, National Institute of Health; Infectious Diseases Consultant, Ministry of Health, Yerevan, Republic of Armenia; sknarina70@mail.ru, sknarina70@yahoo.com
Astkhik S. Davidyan, Infectiologist, National Center for Infectious Diseases; Assistant Lecturer, Department of Infectious Diseases, National Institute of Health, Yerevan, Republic of Armenia; dasdoc@rambler.ru
Svetlana V. Sergeenko, Epidemiologist, Department of HIV Prevention, Republican Center for Hygiene, Epidemiology, and Public Health, Minsk, Republic of Belarus; svetlana-s.v@mail.ru;
Zhanna A. Saprykina, Head, Monitoring and Evaluation Department, Republican Research and Practical Center for Pulmonology and Phthisiology, Minsk, Republic of Belarus vis3371@mail.ru
Aibek A. Bekbolotov, Deputy Director, Republican AIDS Center, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan; aibek_0001@mail.ru; https://orcid.org/000
Elmira D. Abdrakhmanova., Head, Informatics and Epidemiology Department, National Center for Phthisiology, Ministry of Health, Bishkek, Kyrgyz Republic; elmiraa1@yandex.ru;https://orcid.org/0000-0001-8754-2985
Grigoriy V. Volchenkov, Chief Physician, Centre for Specialised Phthisiopulmonological Care, Владимир, Россия; root@tubdisp.elcom.ru
Tatyana N. Zamkovaya, Head, Regional Center for AIDS Prevention and Control, Vladimir Regional Clinical Hospital, Vladimir, Russia; aids.doctor@yandex.ru
Safarkhon S. Sattorov, Director, Republican Center for AIDS Prevention and Control, Dushanbe, Republic of Tajikistan; s.safar@inbox.ru
Alidzhon A. Soliev, Cand. Med. Sci., Deputy Director for Epidemiological Issues, Republican Center for AIDS Prevention and Control, Dushanbe, Republic of Tajikistan; salijon@mail.ru
Muborak Yu. Bekmetova, Higher-Category Infectiologist, Head, Outpatient Department, Republican Center for AIDS Control, Tashkent, Republic of Uzbekistan; yuldashovna@mail.ru
Gulifar A. Normuratova, Higher-Category Epidemiologist, Deputy Director for Epidemiological Issues, Republican Center for AIDS Control, Tashkent, Republic of Uzbekistan; gulifar@list.ru
Professor Vadim V. Pokrovsky, Academician of the Russian Academy of Sciences, MD, Head, HIV Department, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; pokrovsky.vad@yandex. Ru; https://orcid.org/0000-0002-9514-7288
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