The study of the economic efficiency of early detection of tuberculosis and latent tuberculosis infection, preventive chemotherapy of tuberculosis in comparison with the cost of treatment of tuberculosis with HIV infection. The cost estimate was performed on the basis of the cost of treatment of 179 patients with tuberculosis associated with HIV infection. The cost of preventive measures was calculated based on the data of 5858 HIV-infected patients examined in the Moscow city center for AIDS prevention and control, 912 of them received chemoprophylaxis. For the diagnosis of latent tuberculosis infection, a skin test with a tuberculosis recombinant allergen was used.
The result was calculated average cost of treatment of one patient co-infection HIV/tuberculosis, which according to estimates amounted to 1 342 391.77 RUB, the cost of detection of TB and diagnosis of latent infection – 2363.26 RUB, a course of chemoprophylaxis – 8374.36 RUB. According to estimates, the savings in preventive measures will be 189 100 772.82 RUB (67,7%) per year. Screening for tuberculosis, diagnosis of latent infection and chemoprophylaxis is 3.1 times more profitable than the cost of possible treatment of tuberculosis patients. Тhe real budget savings based on the prevention of tuberculosis for 164 patients with HIV infection in the Moscow in the period 2014-2017 amounted to 134 666 286.32 RUB.

The article contains the results of experimental Toxicological studies of the sensitivity of rats to lethal doses of the TB drug «Isoniazid» in conditions of its combined use with sugar syrup and pyridoxine hydrochloride, as well as after the preliminary consumption of sweetened drinking water. It was found that the use of isoniazid with sugar reduced the toxicity of isoniazid and increase the average life expectancy of rats.

The article considers modern concepts of the principles of determining the drug sensitivity of microorganisms, the criteria for its evaluation used in bacteriology. The data of the retrospective analysis of the results of the sensitivity/resistance of 593 strains of M. tuberculosis to drugs of the fluoroquinolone group (ciprofloxacin, ofloxacin, levofloxacin and moxifloxacin), obtained using the automated system BACTEC™ MGIT™ 960 in different periods, when tested to the different critical concentrations of the drugs recommended by WHO. The regularity of cross-resistance of M. tuberculosis strains to fluoroquinolones is analyzed. It was found that the percentage of cross-resistance changed depending on the critical concentrations of drugs.
In the treatment of tuberculosis with MDR/XDR pathogen, with chemotherapy, including drugs from the group of fluoroquinolones, more complete information on the drug resistance level of M. tuberculosis to these drugs is needed. Determination of drug sensitivity using critical drug concentrations should be supplemented by quantitative methods (determination of MIC).

The drug sensitivity of 74 strains of slow-growing Mycobacterium species M. xenopi was studied using the method of serial microdilutions – Sensititre SlowMyco (TREK DIAGNOSTIC Systems Ltd., UK).
It was found that this species of NTM is more often resistant to «basic» anti-tuberculosis drugs, and to other chemotherapy drugs used for the treatment of relevant mycobacterioses, according to different authors, may be sensitive or resistant.
The results of the studies described in this paper confirm these positions and give a more detailed description of the degree of sensitivity/ resistance of M. xenopi to the main drugs.

The article presents the results of determining the values of the minimum inhibitory concentration (MIC) of bedaquiline to the first line anti-tuberculosis drugs (ATD) of the main series of 100 clinical strains of M. tuberculosis in different nutrient media. The studies were
carried out in the liquid Middlebrook 7H9 (M7H9) medium using an automated system BACTEC™ MGIT™ 960 and 96-well panel, as well as on the agar medium Middlebrook 7H11 (М7Н11). Based on the obtained data, the ranges of MIC values were determined: in the liquid medium M7H9 − from 0.03 to 0.25 μg/ml, agar М7Н11 − from ≤0.015 to 0.03 μg/ml. For sensitive strains of M. tuberculosis, the limit values of MIC were determined: 0.25 μg/ml in M7H9 liquid medium and 0.03 μg/ml in М7Н11 agar medium.

Misuse (inappropriate or imprudent use) of anti-tuberculosis drugs is one of the reasons to the ongoing spread of drug-resistant tuberculosis. So, the problem of rational therapy for tuberculosis is still of urgent interest. With the present abundance of drugs for tuberculosis, patients can be cured, on the one hand, but on the other hand, a serious harm to patients’ health can be inflicted. Hence, physicians are required to have knowledge of both pharmacological drug properties and personalized approach to patients. This article features basic principles of rational drug choice for tuberculosis, combining drugs, drug formulations, and drug dosages. Factors complicating pharmacotherapy in children and the elderly patients are specified. The issues related to off-label drug use are contemplated. Key factors and methods to improve the effectiveness of pharmacotherapy for tuberculosis are pointed out.

In order to assess the effect of the N-acetyltransferase 2 genotype on the risk of drug-induced liver damage in patients with tuberculosis, and to compare the results of the prognosis for clinical and pharmacogenetic data, a prospective cohort study was conducted. 49 new pulmonary tuberculosis patients were included, 25 with genotype corresponded to the slow type of acetylation (the 1st cohort) and 24 with genotype of the fast type (2nd cohort). The incidence of drug-induced liver injury during the intensive phase of antituberculous chemotherapy in the 1st cohort was 56.0%, in the 2nd cohort 20.8% (OR 2.69, 95%CI 1.14–6.31).The risk assessment for hepatotoxic reactions based on the genotype N-acetyltransferase was comparable to the clinical scale of the risk assessment; with the combined use of the scale and pharmacogenetic testing, the prognosis accuracy increased to 72.3% (95%CI 58.1–83.2%).

The article considers the causes of deaths in HIV-infected patients with suppurative lung and pleura diseases according to the Pokrovskaya Hospital (Saint-Petersburg city) for 2012–2016 (24 patients). The main death cause of patients were intoxication and respiratory insufficiency due to the progression of purulent-inflammatory process in the lungs and immunosuppression.
The most important factors in deceased patients were the prevalence of the infectious-destructive process in the lungs, with frequent bilateral changes, the domination of nosocomial flora, and the lack of therapy in the presence of severe immunodeficiency.

Described a long-term observation (2009–2016) of the course and outcome of tuberculosis in a child with perinatal HIV infection. The case demonstrates the natural history of HIV/TB co-infection in the young child in the absence of any preventive measures against HIV infection and tuberculosis. It is also revealed the potential of complex treatment with the use of anti-TB and antiretroviral drugs, considering drug resistance of pathogens, and favourable influence on the course of co-infection careful medical supervision and the treatment adherence of parents.