The aim of the study was to develop a methodology for classifying territories based on the analysis of tuberculosis incidence and mortality rates from this disease, taking into account the principle of clarity.
Materials and methods. Оfficial data from state statistical observations for the constituent entities of the Russian Federation for 2007, 2010, 2014 and 2019 and data for the administrative districts of Moscow for 2019 were used for the analysis using cluster analysis methods and the Kruskal – Wallis’s test.
Results. Тhe classification showed the presence of five groups of territories that differ significantly in terms of variation statistics and the identified ranges of maximum and minimum morbidity and mortality values. Since 2010, there has been a shift in the number of territories in the 1st and 2nd groups and a decrease in their number in the 4th and 5th groups; medians, averages and group boundaries are changing towards a decrease in morbidity and mortality. This confirms the improvement of the epidemiological situation for tuberculosis in Russia over these years. Four regions were allocated for Moscow. Significant intergroup differences in the incidence rate were shown (p < 0.05); for the mortality rate the differences were insignificant (p = 0.057).
Conclusion. Мethod for classifying territories according to the main epidemiological indicators for tuberculosis was developed. It can be considered as a tool for comparison of regions, used to assess the quality and effectiveness of anti-tuberculosis measures, and to develop management decisions.

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.

Aim. To determine the place and structure of malignancies in tuberculosis patients.
Material and methods. The retrospective study used the data of the regional epidemiological system of TB monitoring, reporting forms № 33 for 2018–2024. During this time 157 TB patients aged ≥18 years with concomitant oncopathology were discharged from the Moscow Research and Clinical Center for Tuberculosis Control. Among them there were 106 (67.5%) men and 51 (32.5%) women.
Results. Cancer in TB patients was 2-fold more common in men (67.5%) than in women (32.5%), occurring in 63.2% (67 out of 106) of cases between the ages of 51–70 years in men and in 55.4% among all patients (87 out of 157). The main clinical form of TB was infiltrative (47.1%), less frequently tuberculoma (10.8%), disseminated (7.0%) and fibrotic cavernous TB (6.4%). The genitourinary system (39.5%) was the most frequently affected by cancer processes, the organs of the digestive (17.8%) and respiratory (16.4%) systems were less frequently affected. The combination of cancer and TB in the same organ system was found in 25 (16.6%) of 151 lung TB patients and in 2 (5.9%) of 34 kidney TB patients. The overwhelming majority (91.1%) of patients had active TB in various combinations: respiratory TB in 86.6%, extrapulmonary TB in 1.9%, combined respiratory and extrapulmonary TB in 1.3%, and active extrapulmonary TB with a history of cured respiratory TB in 1.3%.
Conclusion. The peak incidence of TB/cancer combined pathology is at the age of 51–70 years mainly due to men. The structure of oncological pathology in TB patients is dominated by tumors of extrapulmonary localization with predominance of neoplasms of genitourinary, digestive and respiratory organs.

Aim. Determine the diagnostic capabilities of the IGRA test system based on the ELISPOT platform in detecting specifically sensitized cells in bronchoalveolar lavage fluid of patients with pulmonary tuberculosis, including patients with HIV infection.
Materials and methods. The sensitivity of the ELISPOT laboratory test system was analyzed in the study of bronchoalveolar lavage fluid and peripheral blood from 70 patients with newly diagnosed pulmonary tuberculosis and 31 patients with HIV-tuberculosis coinfection. Samples from each patient were examined by the immunological method using the T-SPOT®.TB test system (Oxford Immunotec Limited, UK).
Results. In HIV-negative patients, bronchoalveolar lavage fluid analysis can increase the clinical sensitivity of the laboratory test system to 81.4% (95%CI 70.8-88.8%) compared with peripheral blood analysis (74.3%; 95%CI 63.0-83.1%). In HIV-infected patients, examination of bronchoalveolar lavage fluid resulted in a decrease in the clinical sensitivity of the test system to 61.3% (95% CI 43.8-76.3%) compared with peripheral blood analysis (77.4%, 95%CI 60.2-88.6%; p<0.05).
Conclusion. Examination of bronchoalveolar lavage fluid using the T-SPOT® test system.TB helps to increase the detection of tuberculosis infection predominantly in uninfected HIV patients.

Aim. To assess the serum concentration of cytokines at various phases of chemotherapy for pulmonary tuberculosis as an additional laboratory criterion for transferring patients from the intensive phase of therapy to the continuation phase.
Materials and methods. In patients of three study groups, comparable in forms of pulmonary tuberculosis, hemogram parameters, protein and cytokine levels (IL-6, IL-10, VEGF-A) were determined before chemotherapy (Group I, n = 41), in the intensive phase (Group II, n = 39) and continuation phase (Group III, n = 32). The control group consisted of 20 healthy individuals, comparable in age and gender with patients with pulmonary tuberculosis.
Results. A significant increase of IL-6 and VEGF-A (12.9 and 382.4 pg/ml) was revealed before the start of chemotherapy, by 2.5 and 2.1 times compared to the values in the control group (pI-k < 0.01), as well as their 1.7 and 1.5 times lower levels in the continuation phase compared to the initial (pI-III < 0.05), and a positive correlation of the expression of IL-6 and VEGF-A with the ESR and CRP indicators (r was 0.76 and 0.59 respectively, for correlation with ESR; 0.8 and 0.7 for CRP, p < 0.05).
Conclusion. It is advisable to use the determination of IL-6 and VEGF-A levels as an additional laboratory criterion when transferring pulmonary TB patients from the intensive phase of therapy to the continuation phase.

The organization of anti-tuberculosis care for the population and its adaptation to new conditions under the external adverse impact of wars, epidemics, transformation of the state structure, etc. is of great importance for phthisiologists and health care organizers.
Aim. To study the pathomorphosis of tuberculosis and analyze the historical experience of changing the system of organizing antituberculosis care in the USSR during the Great Patriotic War.
Materials and methods. A systematic search of the CIBERLENINKA, ELIBRARY.RU, PubMed, Rusneb.ru, Central National Library of Russia, and libraries of the Central Research Institute of Tuberculosis, Moscow City Department of Health, for the period from 1938 to 2025, included 9037 sources, 43 publications were selected: collections of scientific papers, books, scientific articles, regulatory documents of the USSR People’s Commissariat of Health, the RSFSR People’s Commissariat of Health, the USSR State Defense Committee, one website.
Results and discussions. The system of anti-tuberculosis measures was restructured as when working with an infectious disease. The registration of all patients with tuberculosis was intensified with notification of sanitary services. In addition to clinical work, dispensaries were charged with collecting statistical data, anti-epidemic work, health education of the population, work with non-tuberculosis medical organizations. Trade unions, social services, the People’s Commissariat of Education were involved in the fight against tuberculosis using their resources. A wider network of anti-tuberculosis and health institutions for children and adults, nursing homes for war invalids with tuberculosis were developed. Additional nutrition was introduced for patients with tuberculosis; they were provided with easier work with additional payment of the difference in salary at the expense of social insurance funds. The personnel of scientific and practical anti-tuberculosis medical organizations were preserved and increased.
Conclusion. The war became a catalyst for progress in the organization of anti-tuberculosis care for the population. In the pre-antibacterial era, tuberculosis epidemics were prevented in the army and among the civilian population through a range of organizational, sanitary and social measures.

A rare clinical case of isolated liver tuberculosis has been demonstrated. Differential diagnosis and diagnosis of tuberculosis of this localization present significant difficulties for a doctor of general medical network. The histological examination of biopsy or surgical material obtained during laparoscopy plays a crucial role in verifying the diagnosis. Due to the patient’s complaints of aching abdominal pain, prolonged unexplained subfebrile temperature, normal results of the routine clinical examination, and difficulties in differential diagnosis, this clinical observation is of professional interest to doctors of various specialties.