Русский
Factors influencing availability and adherence to tuberculosis chemoprophylaxis in people living with HIV
DOI: https://dx.doi.org/10.18565/epidem.2025.15.4.54-62
Kulabukhova E.I., Vinokurova O.O., Kuznetsova E.N., Filippova V.O., Sidorenko N.Yu., Pokrovskaya A.V.
1) Patrice Lumumba Peoples’ Friendship University of Russia, Moscow, Russia; 2) Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; 3) National Medical Research Center for Phthisiopulmonology and Infectious Diseases, Moscow, Russia; 4) Autonomous Non-Commercial Organization, Center for Assistance to Partnership in Healthcare «Zdorovye.ru», Moscow, Russia
Materials and methods. In the first half of 2025, an anonymous online survey was conducted among 239 HIV-positive patients from 34 regions of Russia and 53 infectious disease physicians working with HIV-positive patients living in Russia. The surveyed physicians and patients were not linked.
Results. Among the patients surveyed, only 104 (43.5%) received at least one of the four WHO-recommended tuberculosis screening questions during their doctor’s appointment at the AIDS center. The odds of being prescribed TB CP were significantly increased by: screening for four WHO symptoms (odds ratio (OR) 2.4, 95% CI 1.3–4.4; p = 0.004) and having a TB specialist at the AIDS center (OR 2.3, 95% CI 1.2–4.4; p = 0.014). A CD4+ lymphocyte count > 500 cells/μL reduced the odds of being prescribed TB CP by 93% (OR 0.067, 95% CI 0.02–0.21; p = 0.000). The proportion of patients who completed the TB CP course was higher among those informed about adverse events and methods for their prevention.
Conclusion. Considering that more than a quarter of physicians doubt the effectiveness of TB CP or consider it a formality, yet most specialists would like to receive additional information on this topic, training infectious disease physicians with a focus on patient concerns and current clinical guidelines will increase the frequency of TB CP prescription, patient adherence, and, consequently, the effectiveness of preventive measures.
Literature
1. Global tuberculosis report 2024. Geneva: World Health Organization; 2024. Licence: CC BY-NC-SA 3.0 IGO 2. Васильева И.А., Стерликов С.А., Тестов В.В., Михайлова Ю.В., Голубев Н.А,. Кучерявая Д.А. и др. Ресурсы и деятельность противотуберкулёзных организаций Российской Федерации в 2022–2023 гг. М.: РИО ЦНИИОИЗ, 2024. 94 с. Vasilyeva I.A., Sterlikov S.A., Testov V.V., Mikhailova Yu.V., Golubev N.A., Kucheryavaya D.A. et al, (Resources and activities of anti-tuberculosis organizations of the Russian Federation in 2022–2023). Moscow: Russian Research Institute of Health, 2024. 94 p. (In Russ.). 3. Badje A., Moh R., Gabillard D., Guéhi C., Kabran M., Ntakpé J.B. Temprano ANRS 12136 Study Group. Effect of isoniazid preventive therapy on risk of death in west African, HIV-infected adults with high CD4 cell counts: long-term follow-up of the Temprano ANRS 12136 trial. Lancet Glob. Health 2017; 5(11): e1080-e1089. DOI: 10.1016/S2214-109X(17)30372-8 4. Suthar A.B., Lawn D.L., Amo J., Getahun H., Dye C., Sculier D. et al. Antiretroviral Therapy for Prevention of Tuberculosis in Adults with HIV: A Systematic Review and Meta-Analysis. PLoS Medicine 2012; 9(7): e1001270. DOI: 10.1371/journal.pmed.1001270. 5. Подымова А.С., Жуков В.В. Результаты химиопрофилактики туберкулеза у больных с ВИЧ-инфекцией в Свердловской области. ВИЧ-инфекция и иммуносупрессии 2016; 8(3): 101–107. DOI: 10.22328/2077-9828-2016-8-3-101-107 Podymova A.S., Zhukov V.V. (The results of preventive chemotherapy for latent tuberculosis in HIV patients in Sverdlovsk Region). HIV Infection and Immunosuppressive Disorders 2016; 8(3): 101–107. (In Russ.). DOI: 10.22328/2077-9828-2016-8-3-101-107 6. Синицын М.В., Кривцова О.В., Белиловский Е.М., Аюшеева Л.Б., Богородская Е.М. Экономическая эффективность диагностики латентной туберкулезной инфекции и химиопрофилактики туберкулеза у больных ВИЧ-инфекцией, Туберкулез и социально значимые заболевания 2018; (3): 4–13. Sinitsyn M.V., Krivtsova O.V., Belilovsky E.M., Ayusheeva L.B., Bogorodskaya E.M. (Economic efficiency of latent tuberculosis infection diagnostics and chemoprophylaxis of tuberculosis in patients with HIV-infection). Tuberculosis and socially significant diseases 2018; (3): 4–13. (In Russ.). 7. Туберкулез у взрослых: Клинические рекомендации. М.: Российское общество фтизиатров, 2024. https://rof-tb.ru/structure/ (Tuberculosis in adults: Clinical recommendations). Moscow; Russian Society of Phthisiologists, 2024. (In Russ.). https://rof-tb.ru/structure/ 8. WHO consolidated guidelines on tuberculosis. Module 4: treatment and care. Geneva: World Health Organization; 2025. 9. Рекомендации по лечению ВИЧ-инфекции и связанных с ней заболеваний, химиопрофилактике заражения ВИЧ. 2024. Эпидемиол. инфекц. болезни. Актуал. вопр. 2024; 14(4, приложение). 108 с. (HIV-infection in adults 2024. Recommendations for the treatment of HIV infection and related diseases, chemoprophylaxis of HIV infection). Epidemiology and infectious diseases. Current items 2024; 14(4,supplement). 108 p. (In Russ.). 10. Сборник передового опыта реализации Стратегии ликвидации туберкулеза и рекомендаций ВОЗ по профилактике и борьбе с туберкулезом в Российской Федерации. Копенгаген: Европейское региональное бюро ВОЗ; 2025. https://iris.who.int/items/e5024625-9583-44a3-b022-720228eae858 (Compendium of good practices in the implementation of the Tuberculosis Action Plan and WHO guidelines for the prevention and treatment of tuberculosis in Russian Federation). Copenhagen: WHO Regional Office for Europe; 2025. (In Russ.). https://iris.who.int/items/e5024625-9583-44a3-b022-720228eae858 11. Капустин Д.В., Краснова Е.И., Хохлова Н.И., Сташевская Ю.А., Пудова Е.С., Позднякова Л.Л. Эффективность химиопрофилактики туберкулеза у больных ВИЧ-инфекцией в Новосибирской области. Туберкулез и болезни легких 2023; 101(1): 63–67. DOI: 10.58838/2075-1230-2023-101-1-63-67 Kapustin D.V., Krasnova E.I., Khokhlova N.I., Stashevskaya Yu.A., Pudova E.S., Pozdnyakova L.L. (Efficacy of Preventive Chemotherapy of Tuberculosis in HIV Infected Patients in Novosibirsk Oblast). Tuberculosis and Lung Diseases 2023; 101(1): 63–67. (In Russ.) DOI: 10.58838/2075-1230-2023-101-1-63-67 12. Загдын З.М., Дырул С.И., Шенои Ш., Исаева Г.Н., Гаврилова О.В., Лебедева Е.Н. и др. Короткий 3-месячный курс сочетания изониазида и пиразинамида в сравнении с 6-месячным режимом изониазида в профилактике туберкулеза среди ВИЧ-инфицированных взрослых: рандомизированное клиническое исследование. ВИЧ-инфекция и иммуносупрессии 2017; 9(3): 54–64. DOI: 10.22328/2077-9828-2017-9-3-54-64 Zagdyn Z.M., Dyrul S.I., Shenoi S., Isaeva G.N., Gavrilova O.V., Lebedeva E.N. et al. (Short-course isoniazid and pyrazinamide compared with 6-month isoniazid for tuberculosis prevention in HIV-infected adults: the randomized clinical trial). HIV Infection and Immunosuppressive Disorders 2017; 9(3): 54–64. (In Russ.). DOI: 10.22328/2077-9828-2017-9-3-54-64 13. Соловьева А.В., Кутенева Н.В., Кузнецова Т.А., Белова Е.В., Дюжик Е.С., Волченков Г.В. Факторы риска незавершения каскадного принципа оказания медицинской помощи бездомным людям с туберкулезной инфекцией. Туберкулез и болезни легких 2025; 103(1): 36–44. DOI; 10.58838/2075-1230-2025-103-1-36-44 Solovyova A.V., Kuteneva N.V., Kuznetsova T.A., Belova E.V., Dyuzhik E.S., Volchenkov G.V. (Risk Factors for Non-completion of the Cascade Medical Care for Homeless People Infected with Tuberculosis). Tuberculosis and Lung Diseases 2025; 103(1): 36–44. (In Russ.). DOI: 10.58838/2075-1230-2025-103-1-36-44 14. Русановская Г.Ф., Минаева С.В., Сидорова Н.Н., Балаганин В.А., Апоян С.А. Результаты химиопрофилактики туберкулеза у больных ВИЧ-инфекцией на территории Нижегородской области. Туберкулез и болезни легких. 2019 ;97(9): 28–32. DOI: 10.21292/2075-1230-2019-97-9-28-32 Rusanovskaya G.F., Minaeva S.V., Sidorova N.N., Balaganin V.A., Аpoyan S.A. (Results of preventive treatment of tuberculosis in HIV infected patients in Nizhny Novgorod Region). Tuberculosis and Lung Diseases 2019; 97(9): 28–32. (In Russ.). DOI: 10.21292/2075-1230-2019-97-9-28-32 15. Pease C., Hutton B., Yazdi F., Wolfe D., Hamel C., Quach P. et al. Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: a systematic review with network meta-analyses. BMC Infect. Dis. 2017; 17(1): 265-276. DOI: 10.1186/s12879-017-2377-x 16. Moro R.N., Borisov A.S., Saukkonen J., Khan A., Sterling T.R., Villarino M.E. et al. Factors Associated With Noncompletion of Latent Tuberculosis Infection Treatment: Experience From the PREVENT TB Trial in the United States and Canada. Clin. Infect. Dis. 2016; 62(11): 1390–1400. DOI: 10.1093/cid/ciw126 17. Кулабухова Е.И., Зимина В.Н., Сидоренко Н.Ю., Кравченко А.В. Химиопрофилактика туберкулеза у людей, живущих с ВИЧ, с точки зрения пациента. В сб: Инфекционные болезни в современном мире: эволюция, текущие и будущие угрозы. Материалы XI Ежегодного Всероссийского Конгресса по инфекционным болезням с международным участием. М.. 2019; 105. Kulabukhova E.I., Zimina V.N., Sidorenko N.Yu., Kravchenko A.V. (Chemoprophylaxis of tuberculosis in people living with HIV, from the patient’s point of view). In: Infectious Diseases in the Modern World: Evolution, Current and Future Threats. Materials of the 11th Annual All-Russian Congress on Infectious Diseases with International Participation. Moscow. 2019: 105. (In Russ.). 18. Degtyareva S., Hamada Y., Baggaley R.F., Hassan N., Capocci S., Crevel R. et al. Tuberculosis Preventive Treatment care pathways in people living with HIV: a systematic review and meta-analysis. Eur. Respir. J. 2025; 66(2): 2302174. DOI: 10.1183/13993003.02174-2023
About the Autors
Ekaterina I. Kulabukhova, Cand. Med, Sci., Assistant, Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia; Infectiologist, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; ekulabukhova@mail.ru; https://orcid.org/0000-0003-3645-7275
Olga O. Vinokurova, Cand. Med, Sci., Associate Professor, Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, Moscow, Russia; starinakoh@yandex.ru; https://orcid.org/0000-0001-5689-7628
Elena N. Kuznetsova, Assistant, Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia; Phthisiologist, National Medical Research Centre Phthisiopulmonology and Infection Desease, Moscow, Russia;. beloborodova_en@pfur.ru; https://orcid.org/0000-0002-8508-5781
Valeriya O. Filippova, Assistant, Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, Moscow, Russia; vaflpp@yandex.ru; https://orcid.org/0009-0005-8221-8015
Natalia Yu. Sidorenko, Project Manager, Autonomous Non-Commercial Organization «Zdorovye.ru», Moscow, Russia; nsidorenko84@gmail.com; https://orcid.org/0009-0003-8874-6076
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 of Epidemiology and Phthisiology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia; Moscow, Russia; mailto:pokrovskaya@cmd.su; https://orcid.org/0000-0002-2677-0404
Similar Articles
