Dependence of tuberculosis epidemic situation on HI V-infection in Kemerovo

Abstract

Dynamics of the key epidemic parameters of tuberculosis (TB) and HIV + TB coinfection, as well as tuberculosis with no coinfection, was studied for a 5-year period from 2011 to 2015 in a major industrial city in Siberian Federal District cha-racterized by unfavorable epidemic situation in terms of the both diseases considered. HIV-infection incidence caused a decrease in tuberculosis morbidity rate reduction in Kemerovo in 5 years almost by a factor of two: from 46.7 % owing to patients with no HIV-infection to 25.7 %. Tuberculosis prevalence went down insignificantly in the period of study by 8.6 %. At the same time, the prevalence of the disease with no HIV-infection decreased by 30.3 %. The amount of HIV patients among incident patients increased from 11.0 to 34.8 %, and in patient cohorts with active tuberculosis - from 10.9 to 28.8 %. These forms of tuberculosis in HIV-infected patients were detected usually detected after patients’ complaints. Preventive examinations for tuberculosis were ineffective in terms of detection of the disease in HIV-infected patients. New approaches to tuberculosis detection in HIV-infected patients, as well as intensified set of tuberculosis prevention measures in the form of early assignment of antiretroviral therapy and, if indicated, chemical prophylaxis, are required.