Perm Medical JournalPerm Medical Journal0136-14492687-1408Eco-Vector697310.17816/pmj34438-44Research ArticleASSESSMENT OF POTENTIAL ROLE OF PATIENTS WITH ASSOCIATED HIV-INFECTION AND TUBERCULOSIS AS A SOURCE OF TUBERCULOUS INFECTIONSergevninV Iviktor-sergevnin@mail.ruSarmometovE V-ZiminaV N-MikovaO E-VaretskayaT A-15082017344384411092017Copyright © 2017, Sergevnin V.I., Sarmometov E.V., Zimina V.N., Mikova O.E., Varetskaya T.A.2017Aim. To estimate the potential role of patients with associated HIV infection and tuberculosis as a source of tuberculous infection as compared with monotuberculosis patients. Materials and methods. Epidemiological danger of patients was assessed by the degree of bacterioexcretion massiveness and its share in the structure of M. tuberculosis of virulent genotype Beijing. Massiveness of bacterioexcretion was studied by the results of luminescent microscopy and bacteriological analysis of phlegm, genotyping - with test-system “Amplitub-Beijing” and method MIRU-VNTR. Results. It was established that in spite of the lesser quantity of M.tuberculosis, excreted by patients with HIV-infection associated with tuberculosis, as compared to patients with monotuberculosis, coinfected patients more often discharge high-virulent genotype Beijing, therefore, may be more epidemiologically dangerous as a source of tuberculous infection. Conclusions. According to the results of bacteriological study of the phlegm by means of dense nutrient medium, in patients with associated HIV infection and tuberculosis lesser massiveness of M. tuberculosis excretion than in patients with tuberculosis without HIV infection was revealed. In the structure of M. tuberculosis, isolated from patients with associated HIV-infection and tuberculosis, the share of genotype Beijing was more than 90 %, from patients with tuberculosis without HIV-infection - only 70 %.HIV infection associated with tuberculosismassiveness of M. tuberculosis genotype excretionВИЧ-инфекция в сочетании с туберкулезоммассивность выделения и генотипы М. tuberculosis[Корецкая Н.М., Большакова И.А. Биологические свойства микобактерий у ВИЧ-негативных и ВИЧ-позитивных лиц с диссеминированным туберкулезом. Сибирское медицинское обозрение 2012; 4: 62-66.][Мокроусов И.В. Методические подходы к генотипированию Mycobacterium tuberculosis для эволюционных и эпидемиологических исследований. Инфекция и иммунитет 2012; 3: 603-614.][О совершенствовании противотуберкулезных мероприятий в Российской Федерации: Приказ Минздрава РФ № 109 от 21 марта 2003 г. (ред. от 29.10.2009), available at: http://urobcg.ru/documents/recommend/_1_ prikaz_o_sovershenstvovanii_protivotuberkulez- nih_ meroprijatij_v_rosijskoi_federacii.pdf.][Отдушкина Л.Ю. Биологические свойства кокковой микрофлоры кишечника у ВИЧ-инфицированных детей. Медицина в Кузбассе 2015; 4: 14-18.][Попова А.А., Синдыкова Ю.Р., Кравченко А.В., Серебровская Л.В. Изменения системы иммунитета у больных ВИЧ-инфекцией и туберкулезом. Эпидемиология и инфекционные болезни 2008; 4: 54-55.][Савилов Е.Д., Синьков В.В., Огарков О.Б. Эпидемиология туберкулеза на Евроазиатском континенте. Оценка глобального движения штаммов генотипа «Пекин». Иркутск: 121. ИГМАПО 2013; 121.][Шеховцова О.В., Шаталова Е.В. Механизм формирования госпитальных штаммов возбудителей внутрибольничных инфекций и способ их предупреждения. Клиническая лабораторная диагностика 2012; 7: 58-61.][Cain K.P., McCarthy K.D., Heilig C.M. An algorithm for tuberculosis screening and diagnosis in people with HIV. N Engl J Med 2010. 362 (8); 707-716.][Caminero J.A., Pena M.J., Campos-Herrero M.I. Epidemiological evidence of the spread of a Myco-bacterium tuberculosis strain of the Beijing genotype on Gran Canaria Island. Am J Respir Crit Care Med 2001; 164: 1165-1170.][Linguissi L.S.,Mayengue P.I.,Sidibé A. Prevalence of national treatment algorithm defined smear positive pulmonary tuberculosis in HIV positive patients in Brazzaville, Republic of Congo. BMC Res Notes 2014; 7: 578.][Lopez B., Aguilar D., Orozco H., Burger M., Espi-tia C., Ritacco V., Barrera L., Kremer K., Hernandez-Pando R., Huygen K., Soolingen D. van. A marked difference in pathogenesis and immune response induced by different Mycobacterium tuberculosis genotypes. Clin Exp Immunol 2003; 133: 30-37.]