Features of newly diagnosed tuberculosis in women of reproductive age, patients with HIV infection in Nizhny Novgorod region

Aim. To study the features of newly diagnosed tuberculosis combined with HIV infection in women of reproductive age 18–44 years in Nizhny Novgorod region.
Materials and methods. Based on the official accounting forms of the federal statistical reporting No. 263/u-TB, a statistical analysis of data for the 5-year period from 2015 to 2019 was carried out. The features of newly diagnosed tuberculosis in women of reproductive age with HIV infection in Nizhny Novgorod region were calculated. 
Results. The average age of HIV-infected women with tuberculosis in Nizhny Novgorod region was 33,9±2,4 years. Active tuberculosis was detected in women of reproductive age in HIV-infected populations (69.5%) more often in the range of 6 to 10 years of follow-up for HIV infection (30.9%), at stage 4A of the disease (63.3%) with irregular administration of ART (51.3%) and low immune status (CD4+ lymphocyte count ≤ 350 cells/ml, in 62.7%). The main method of detecting active tuberculosis was radiological (85.6%), advanced forms of respiratory tuberculosis were diagnosed (disseminated – 54.1%, infiltrative in 34.3%), a combination of thoracic and extrathoracic localizations (27.5%) with a large extent of the lesion, the presence of destructive changes (85.5%), bacterial excretion (84.3%), confirmed by cultural (70.0%) and molecular genetic methods (70.2%), with drug resistance to anti-tuberculosis drugs of the first line, including MDR-TB, which indicates the untimely detection of the disease (in 68.2%) when applying with complaints (71.0%) to a general hospital (45.1%).
Conclusion. It is recommended to include HIV-infected women of reproductive age (18 to 44 years) in the risk group for tuberculosis, with the strengthening of treatment, diagnostic, preventive and anti-epidemic measures in the direction of timely diagnosis and chemoprophylaxis of tuberculosis, early administration of antiretroviral therapy, and the formation of adherence to treatment, taking into account the labor and reproductive potential of this population group.

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