tibljТуберкулез и болезни легкихTuberculosis and Lung Diseases2075-12302542-1506Медицинские знания и технологии10.21292/2075-1230-2019-97-3-46-53tiblj-1252Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWБЕЗОПАСНОСТЬ ТЕРАПИИ ТУБЕРКУЛЕЗА С МНОЖЕСТВЕННОЙ ЛЕКАРСТВЕННОЙ УСТОЙЧИВОСТЬЮ ВОЗБУДИТЕЛЯ У БОЛЬНЫХ ВИЧ-ИНФЕКЦИЕЙ, ПОЛУЧАЮЩИХ АНТИРЕТРОВИРУСНУЮ ТЕРАПИЮTHE SAFETY OF TREATMENT OF MULTIPLE DRUG RESISTANT TUBERCULOSIS IN HIV POSITIVE PATIENTS RECEIVING ANTIRETROVIRAL THERAPYДегтяреваС. Ю.DegtyarevaS. Yu.

ассистент кафедры инфекционных болезней с курсами эпидемиологии и фтизиатрии медицинского института

Assistant of the Infectious Diseases Department with Training Courses in Epidemiology and Phthisiology of the Medical Institute

degtyareva_svet@mail.ruБелобородоваЕ. Н.BeloborodovaE. N.

ассистент кафедры инфекционных болезней с курсами эпидемиологии и фтизиатрии медицинского института

Assistant of the Infectious Diseases Department with Training Courses in Epidemiology and Phthisiology of the Medical Institute

beloborodova_en@rudn.ruПокровскаяА. В.PokrovskayaA. V.

кандидат медицинских наук, старший научный сотрудник

Candidate of Medical Sciences, Senior Researcher

pokrovskaya_av@mail.ruКлимоваЮ. А.KlimovaYu. A.

ассистент кафедры инфекционных болезней с курсами эпидемиологии и фтизиатрии медицинского института

Assistant of the Infectious Diseases Department with Training Courses in Epidemiology and Phthisiology of the Medical Institute

boxofjulia@mail.ruВиктороваИ. Б.ViktorovaI. B.

кандидат медицинских наук, доцент кафедры фтизиопульмонологии

Candidate of Medical Sciences, Associate Professor of Phthisiopulmonology Department

irinaviktoroff@mail.ruЗиминаВ. Н.ZiminaV. N.

доктор медицинских наук, профессор кафедры инфекционных болезней с курсами эпидемиологии и фтизиатрии медицинского института

Doctor of Medical Sciences, Professor of the Infectious Diseases Department with Training Courses in Epidemiology and Phthisiology of the Medical Institute

zim@yandex.ruФГАОУ ВО «Российский университет дружбы народов», г. МоскваРоссияPeople's Friendship University of Russia, MoscowRussian FederationФГАОУ ВО «Российский университет дружбы народов», г. Москва; ФБУН «Центральный НИИ эпидемиологии» Роспотребнадзора, г. МоскваРоссияPeople's Friendship University of Russia, Moscow; Central Research Institute of Epidemiology, the Federal Service on Customers' Rights Protection and Human Well-being Surveillance, MoscowRussian FederationНовокузнецкий государственный институт усовершенствования врачей ‒ филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» МЗ РФ, г. НовокузнецкРоссияNovokuznetsk State Institute for Doctors' Professional Development – Branch of Russian Medical Academy of Continuing Professional Education, NovokuznetskRussian Federation2019030420199734653Copyright © Дегтярева С.Ю., Белобородова Е.Н., Покровская А.В., Климова Ю.А., Викторова И.Б., Зимина В.Н., 20192019Дегтярева С.Ю., Белобородова Е.Н., Покровская А.В., Климова Ю.А., Викторова И.Б., Зимина В.Н.Degtyareva S.Y., Beloborodova E.N., Pokrovskaya A.V., Klimova Y.A., Viktorova I.B., Zimina V.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tibl-journal.com/jour/article/view/1252

В обзоре проанализированы исследования и метаанализы, посвященные терапии туберкулеза с множественной лекарственной устойчивостью возбудителя в сочетании с антиретровирусной терапией как возможного фактора риска нежелательных явлений и худших исходов терапии. Всего в анализ включено 18 источников из русско- и англоязычных информационных баз данных. Большинство исследований не выявили достоверной связи между одновременным приемом антиретровирусной и противотуберкулезной терапии препаратами резервного ряда и увеличением частоты нежелательных явлений. В то же время в наиболее крупных исследованиях, а также исследованиях, посвященных отдельным группам нежелательных явлений, удалось доказать наличие подобной связи. Данные о структуре нежелательных явлений также существенно отличаются по результатам, полученным различными авторами. Большинство исследований проведены в странах Африки с высокой распространенностью ВИЧ-инфекции.

The review analyzed the studies and meta-analyses devoted the treatment of multiple drug resistant tuberculosis in combination with antiretroviral therapy as a possible risk factor of adverse events and the worst outcomes of therapy. In total, the analysis included 18 sources from the Russian and English databases. Most of the studies did not reveal a confident relation between the simultaneous use of antiretroviral and anti-tuberculosis therapy with second line drugs and increased frequency of adverse events. At the same time, in the largest studies, as well as studies devoted to certain adverse events, the authors managed to prove the existence of such a connection. Data on the structure of adverse events also significantly differed in the results obtained by various authors. Most trials were conducted in African countries with a high prevalence of HIV infection.

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The authors declare that there are no conflicts of interest present.