The article assesses the impact of the spread of HIV on TB incidence in a metropolis. On the basis of information from the register of TB monitoring of 2013–2014 a comparative analysis was conducted of new TB cases with and without HIV co-infection. The results showed that patients with HIV/TB co-infection more frequently than other TB patients were: the city’s residents, from age group 31–40 years old, males, unemployed, lack the cavity in lung tissue and the presence of largely disseminated form of TB for pulmonary TB patients, for the latter is also characterized by the fact of stay of the patient in prison in the past. A significant proportion of these patients have localized TB disease in the intrathoracic lymph nodes, with relatively high level of share of bacterial excretion. Despite the overall decline in the proportion of the presence of HIV infection among TB patients in the city of Moscow, the findings point to a significant influence of HIV coinfection of TB incidence rates and to new TB cases characteristics.

In the Perm Region, with a decrease in the total burden of tuberculosis in children, in 40.5% of cases there is information on the contact with TB patients, including patients with comorbidity of HIV + tuberculosis and drug-resistant pathogen. The assessment of epidemiological characteristics and quality of diagnosis of tuberculosis in the foci of infection has been performed. It has been found that the average ratio of the number of contacts to TB patients does not exceed 1,5 : 1, and 31.5% of the total number of contacts are children and teenagers. Of these 40.4% are children from the foci of MBT+, including 7.8% of cases with multi- and 3.4% of cases with extensively drug-resistant pathogen. At the same time, in 1.2% and 0.6% of cases, respectively, this risk factor is accompanied by the
presence of HIV infection in patients. These children are particularly at risk, so the obligatory diagnostic methods include application of tuberculosis recombinant allergen, CT of chest, full, adequate and well-controlled preventive treatment taking into account resistance in the focus. In addition, final disinfection in the foci of TB infection should be conducted.

The incidence of TB decreased. Heavy tuberculosis in children is rare. Tuberculosis associated with HIV in children under 3% of cases. A new method of screening children for TB infection suggests that 2.2% of the child population are at high risk of tuberculosis.

We offer new pediatric x-ray exam algorithm, based on the analysis of diagnostic values of x-ray imaging methods used to examine children and adolescents for primary tuberculosis complex in the lungs, and analysis of radiation dose effects on the patients. Taking into consideration the superior (by a factor of 2-2.5) diagnostic value of computed tomography (CT), compared to conventional x-ray methods, in detecting the abnormalities in lymph nodes and in the lungs, we would suggest extensive use of CT, avoiding plain chest
x-ray and linear tomography, not in Tuberculosis Clinics alone, but in all healthcare facilities equipped with CT scanners.

The treatment assessment of the new tuberculosis patients 18-30 years old with lung tissue destruction performed based on the clinical, laboratory and X-ray criteria of effectiveness and safety. The fixed dose combination «Isocomb» (four first-line antituberculosis drugs and pyridoxine) was compared with four mono-component first-line antituberculosis drugs. Based on the data obtained in 91 patients, the equal effectiveness of various pharmaceutical form in the intensive phase of the I standard treatment regimen was proved.

In the last years the steady increasing of the XDR-tuberculosis occurred and it’s treatment is the difficult problem due to the inability of the adequate chemotherapy regimen and severe adverse events (SAE). The new antituberculosis drugs can give such patients the chance of effective treatment. The data on the chemotherapy regimen included thioureidoiminomethylpyridinii perchloras (TPP) in 41 XDRTB patients. This regimen by sputum conversion rate is commensurate with conventional regimens: at the end of the 8th month of the treatment it was achieved in 66.0% patients compared with 74.0% in the control group. SAE were registered in the both group with similar rate, but in TPP-containing regimens the predominance of toxicallergic and neurotoxic SAE was obtained, and gastrointestinal – in control group. It should be noted, that SAE IV grade (22,0%), caused the remove of the TPP, were registered in the first few days of TPP administration.

The surgical and biopsy specimens from 59 patients with HIVassociated intestinal lesions were considered. In all cases were observed the extended involvement of the gastrointestinal tract, acute progressive tuberculosis with necrotization and exudative tissue alteration, purulent necrosis with completely lost signs of granulomatous inflammation, without tendency of delimitation, what can cause the certain difficulties in pathological interpretation. The extensive disorders of the intestinal wall circulation reinforce the chance of destruction. The concomitant opportunistic infections have the indistinct pathological pattern and polymorphic tissue damage. For the proper morphological verification of the intestinal process the comprehensive pathological examination of specimens is essential.
By the clinical point of view, the peculiarities of tuberculosis in severe immunosuppressed patients must be considered and management of this category of patient must be corrected.

193 patients with ureteral stones underwent endoscopic surgical treatment. 90 (46.6%) of them suffered from obstructive pyelonephritis (I group), 103 (53.3%) – were free of such complication (II group). Hospital stay was longer in group I vs. II: 5.5 days vs. 4.3, respectively (p < 0.05). Next day after surgery the blood leukocytes level decreasing occurred in the both groups: 10.6 ± 0.37 × 109/l in the I group vs. 8.4 ± 0.16 in the II (p < 0.001); normalization of the creatinine level obtained: 97.2 ± 5.1 μmol/l vs. 92.4 ± 3.1, respectively (p > 0.05). So, endoscopic treatment of urinary stone disease complicated by acute pyelonephritis is very effective and safe as one without inflammatory process.