Introduction. The combination of tuberculosis (TB) and HIV infection is a significant medical and social problem, since this new comorbid condition is characterized by a more severe component due to the predominance of drug resistant tuberculosis (MDR TB), which adversely affects the outcomes of treatment.
Aim. To investigate the diversity of clinical forms among patients with MDR TB/HIV depending on the severity of immunosuppression.
Materials and methods. Under observation, there were 104 patients with MDR TB/HIV. Depending on the degree of immunosuppression, the patients were divided into 3 groups: with CD4 < 50 cells/мl, CD4 < 200 and CD4 > 200 cells/мl. In each group, the types of clinical forms of pulmonary tuberculosis, the prevalence of the process and the presence of destructive changes in the lung tissue, as well as the damage of the process organs to the formation of extrapulmonary forms of tuberculosis, were studied.
Results and discussion. In patients with disseminated TB with a CD4 level < 50 cells/мl, most of all, there is no destruction (55.8%) and miliary TB (28.9%). For patients with CD4 < 50 cells/мl, predominance of disseminated and miliary forms of TB with a lesion of not only lungs, but also other organs, which confirms hematogenous disemination is typical. Among the extrapulmonary localizations, the lymphatic system, namely, TB of the intra-thoracic lymph nodes, prevails.
Conclusions. It was established that the clinical characteristics of TB directly depend on the level and depth of immunodeficiency in patients with MDR TB/HIV. The deeper immunosuppression, the more generalized tuberculosis lesions were recorded involving lungs and other organ systems, and there was a lack of destruction in the lung tissue.