For latent tuberculosis (TB) infection (LTI) identification in risk groups of the adult population and detection the new TB cases of these patients in 2012–2016 in Moscow were performed 338 165 skin tests with allergen tuberculosis recombinant (ATR), 1136 T-SPOT®. TB tests and 702 – QuantiFERON®-ТВ Gold. The highest LTI rate was obtained in cured TB patients, at the moment of their transfer in the III group of supervision in TB dispensaries (just after the completed course of treatment) or after the completion of the following-up by TB physicians (21.1–22.9%). The next position belong to the individuals in difficult life situation (homeless and other social disadvantage persons) (9.3–10.5%) and TB contacts (5.6–6.1%). The new risk group was identified – adults from the inner circle of children with
positive skin test with ATR (LTI rate 18.4–20.8%). The LTI prevalence in Moscow’s employed population is less than 1.2% (e.g. in mandatory screened for TB employers – 0.8–1.2%, in adults from the inner circle of pregnant – 0.3–1.0%). The new TB cases detection per 1000 persons with LTI amounted to 3.2 in TB contacts, 14.7 – in mandatory screened for TB employers, 28.7 – in adults from the inner circle of children with positive skin test with ATR, 135.7 – in cured TB patients (after the completed course of treatment), 192.6 – in individuals in difficult life situation. So, in the relatively favorable TB situation in Moscow, ATR skin test can limit the TB risk groups.

The study includes results of 30 749 skin tests with the recombinant TB allergen (RTBA test) delivered for individuals from TB risk groups in frame of the project in out-patient clinics of the South-West administrative district of Moscow in 2015 and the first half of 2016.
Positive results of RTBA test reported for 190 people or 6.2 per 1,000 surveyed, and doubtful reactions – for 96 people or 3.1 per 1000 patients. Persons of 60–80 years old (80.7%) dominated among those who had doubtful and positive RTBA test reactions. Of the 286 patients with positive and doubtful RTBA test 249 (87.7%) have completed the survey. They included 166 patients with positive reactions (66.7%) and 83 – with doubtful reactions (33.3%). 241 patients (82%) registered in 0A follow up TB dispensary group (TB-suspected), including 161 (66.8%) with the positive reactions and 80 (33.2%) with doubtful reactions. In IA (new cases) follow up TB dispensary group registered eight persons (3.2%). 111 patients (50.4% male and 49.6% female) had completed preventive chemotherapy (69%). Among these persons, 97 were older than 55 years (87.4%); 35 patients (31.5%) were at risk for diabetes, 27 (24.3%) – for chronic lung disease, 19 (17.2%) – for chronic gastrointestinal diseases, 25 (22.5%) – for chronic genitourinary diseases, and five (4.5%) were just removed from the register in TB facilities as cured less than three years ago. The tests positive results were divided by papule size in three groups: 5–9 mm – 17 patients (15.3%), 10–14 mm – 20 (18%), 15 mm and more – 74 (66.7%). After 3 months of preventive chemotherapy, all 111 patients retested and 9.0% of them had negative results and 9.9% – doubtful. In 89 patients (80.2%) test results remained positive, but significant decrease (p <0,01) of the mean papule size was obtained: from 16.6 to 9.9 mm.

The results of X-ray and immunological methods for tuberculosis (TB) infection detection of TB healthcare staff in Moscow are presented for the period from 2013 till 2015. It was found out that the rate of TB incidence for this period has inconsiderable fluctuations and the average rate for the three years amounts to 85.6 for 100 thousand of the given group, that three times outperforms the territorial rate of tuberculosis incidence of the Moscow population. The distribution of latent TB infection (LTI) among the relevant organizations staff diagnosed by skin tests with recombinant tuberculosis allergen amounted to 8.6%. The rate of LTI in different groups of medical and nonmedical staff fluctuates from 6.3% to 11.1%. The duration of exposure and the level of mycobacterium impact progressively
increase the risk of LTI in TB healthcare staff. The frequency of LTI detection firmly increases from 5.8% to 10% in the groups with the total years of service up to two years and more than 10 years, and in the observed groups with different professional duties of special
medical treatment – from 0 (the staff of in- and out-patient clinics and sanatoria for children) up to 16.3% (the staff of adults tuberculosis hospitals for immediate and emergency medical care).

The skin test with allergen tuberculosis recombinant (ATR) in 11 279 foreigners and stateless persons, tested in Moscow Research and Clinical Center for TB control (2015, March–May), showed the positive rate 7–18 times more in labor migrants (9.2%) or in migrants
with X-ray abnormalities (16.1%) than in risk groups of Moscow residents, followed up in out-patients clinics (0,87%). The TB detection rate in immigrants with positive ATR test is 173 times more than in ATRnegative (93.6 и 0.5 per 1000, accordingly). Per one patient with active TB in the observed immigrant’s group account about 10 (9.68) persons with latent tuberculosis infection (LTI) – roughly 3000 per year – with the high risk of it manifestation in the next year. The detection of immigrants with LTI allows TB-physicians to personalize prophylaxis and to motivate immigrants for reversal of life-scenario, or to complete the course of the chemoprophylaxis. These activities contribute to the further improvement of TB epidemiological situation in Moscow megalopolis and to decrease the potential cost of immigrants’ treatment of TB, promoted by unfavorable factors.

The study based on the results of skin test with allergen tuberculosis recombinant (ATR) in 100 adult patients in the diagnostic department of the tuberculosis hospital, needed the differential diagnostics of pulmonary tuberculosis (TB).
In patients with non-TB lung diseases in the most part (88.7%) were obtained the negative results of test with ATR. In active TB cases the positive results were obtained in 63.0%, include 33.0% of hyperergic results. In patients with residual TB pulmonary X-ray changes, after effective treatment or spontaneously cured, the positive results were observed in 72.7%. In some cases the discordant results of the ATRtest were registered: positive in non-TB patients (11%) and negative in active TB cases (33%). The obtained data show that, in totally, the ATR-test is high-sensitive and important in the differential diagnostics of pulmonary tuberculosis in adults.
The positive ATR-test results in non-TB patients, such the same in patients with residual TB changes, must be considered as the sings of the latent TB infection and indications for preventive chemotherapy. The negative results of the ATR-test in active TB must be further studied for their reasons clarification.

The study included results of evaluation of the spread of latent tuberculosis infection (LTBI) among HIV-infected persons in Moscow based on the screening conducted at the AIDS Center from 2014 to 2016. The information of the electronic register of the TB-doctor’s office located at the AIDS Center used for data analysis of 6429 patients visited to office in 2006. LTBI detection provided based on results of the skin test with recombinant tuberculosis allergen. The choice of the test was due to its higher sensitivity and specificity in comparison with tuberculin skin test, more convenient to use, accessibility and cost-effectiveness. According to the data received, the LTBI spread in 2016 among HIV people was 5.4%. The low prevalence of LTBI is associated with a favorable overall situation of tuberculosis and the effectiveness of TB preventive activities in the capital city. The value of immunological testing for early TB detection in the absence of X-ray signs of the disease has also been determined. TB screening of HIVinfected persons in Moscow was made possible after a preliminary integration of the TB service and the AIDS Center with the opening of an office for the TB prevention and early TB detection. The detected LTBI patients identified as the target group for conducting preventive therapy aimed at preventing the development of active forms of tuberculosis.

Cryofibrinogenic vasculitis (CV)-associated stenosing ureteritis represents a rare and severe complication of the disease. This article reports on a 40-year-old man with CV with skin and joints involvement who developed a unilateral stenosing ureteritis with atypical
manifestations, demanding left ureter stenting and right punctional nephrostomy. Typical for urogenital TB clinical and radiological findings and absence of the data about ureteric involvement in CV leading to the delay in diagnosis. Patient treated surgically: appendicocaecoureteroplasty with tubularisation of the caecum cap was performed. To clarify the clinical spectrum of this complication, an extensive review of the literature was performed. We emphasize that negative skin tests for TB control should make the diagnosis doubtful.