The literature review describes the current state of the problem of the co-infection (HIV infection/tuberculosis) in pregnant women. Certain questions of tuberculosis detection and diagnostics in pregnant HIV-infected women were discussed. Approaches to treatment of drug susceptible and drug resistant tuberculosis in pregnant HIV-infected women were described with the reference to potential drug interaction. The literature review included the part devoted to specific diagnostics of congenital tuberculosis in children born by mothers with the co-infection. The need of further investigation of the actual issues of HIV/tuberculosis co-infection in the pregnant was highlighted.

The  current diffculties of  differential diagnostics of  pulmonary sarcoidosis have been analyzed in  58 patients. The  duration of the diagnostic period has been described. Clinical, laboratory, X-ray manifestations of pulmonary sarcoidosis have been shown. The predictors of diagnosis verification delay have been detected. The clinical case has been presented with diffculties in dfferential diagnostics of pulmonary sarcoidosis.

The questionnaire survey in 92 TB doctors and 144 general practitioners from polyclinics and hospitals showed the low awareness of the doctors about social problems of tuberculosis patients, which contributed to insuffcient resolution of those problems in tuberculosis patients.

The prospective study evaluated the differential diagnostic value of anti-inflammatory cytokines – tumor necrosis factor-α, interleukin-1β and interleukin-8 in the patients suffering from pleural effusions of various nature (parapneumonic, tuberculous, malignant and transsudate). It was found out that the marker of parapneumonic pleural effusion and pleural empyema was interleukin-8. The high concentration of this cytokine was detected in blood and pleural fluid. Clinical and immunological associations were found out between the level of interleukin-1β in blood/pleural fluid in pleural effusions of tuberculous and malignant nature. The obtained data can be used as additional criteria in differential diagnostics of pleural effusions.

The use of mesenchymal stem cells (MSC) in immune therapy of drug resistant tuberculosis is to be experimentally justified. The impact of non-conditioned and poly(A:U)-conditioned MSC on the course of BCG-infection in mice has been studied. It has been proved that double administration of MSC to mice of BALB/c line in 11 and 12.5 weeks after infection with BCG caused significant reduction of granulomas formation and activated the mycobacterial growth. On the contrary the similar administration of MSC with poly(A:U) conditioning significantly inhibited the mycobacterial growth and provided no effect on granulomas formation. Non-conditioned MSC manifested immune suppression properties, and poly(A:U) conditioning caused their pro-inflammatory polarization in vitro. It has been concluded that MSC therapy of mycobacterial infection can be effective in case of targeted formation of pro-inflammatory immune-phenotype of MSC.

The use of the matrix to analyze mortality from tuberculosis and HIV-infection allows uniting the RF regions into homogeneous groups depending on the mortality level due to both infections. The matrix analysis has proved that only in 23 regions of Russia with low mortality level from both infections the risk of increase in HIV mortality due to the increase of lethal outcomes among tuberculosis patients with concurrent HIV infection is minimal while in the remaining 57 Russian regions it remains high.

With the help of DNA-chip on the Illumina platform the comparative analysis was performed of all genes expression in the lung tissue of two congenic lines of mice – B6 resistant to tuberculosis and much more sensitive B6.1-9.5.7, dierent from B6 only with small region of the 17th chromosome carrying MNC genes of class II. The comparison included healthy mice and mice infected by air-borne transmission~500 CFUЕ of Mycobacterium tuberculosis H37Rv three weeks prior to mRNA isolation. The results were verified by quantitative PCR in real time and it showed that the part of genome which was dierent in the mice lines was so polymorphous that technically it was impossible to use it to compare expression of genes contained in it by methods based on DNA-chips developed specifically for B6 line. On the contrary the eect of the infection on expression of all other genes was defined with high accuracy. It has been shown that in mice of resistant B6 line the number of genes changing the expression at the early phase of the infection is significantly higher compared to the susceptible line of B6.I-9.5.7. The main dierence between two lines of mice is the expression of genes responsible for immune response regulation of cellular cycle and liposome activity. One can suppose that the resistance is based on the involvement into interaction with the causative agent of the significant number of metabolic ways and their regulators.

In vitro studies have proved the anti-tuberculosis eect of FS-1 medication both against susceptible strain of M. tuberculosis H37Rv, and the strain of M. tuberculosis MS-115 with multiple drug resistance.

Conducted in vivo studies on guinea pigs infected with the pathogenic culture of human tuberculosis (strain of H37Rv), have shown that FS-1 provides expressed anti-inflammatory action on the course of experimental tuberculosis. 

Greatly the protective immune response in tuberculosis is defined by the ability of activated pulmonary macrophages of the host to suppress the mycobacterial growth. Macrophages are activated by the action of cytokines and other inflammatory mediators, in particular IFN-γ and TNF-α, secreted by T-lymphocytes. There are two different populations of effector lymphocytes of CD4+CD62LloCD44hi, one of them has the surface phenotype of CD27hi, and the other – CD27lo. Early the experimental model of tuberculous infection has shown that these types of cells have different vitality and abilities to produce inflammatory cytokines of IFN-γ and TNF-α. The effect of these cells on bacteriostatic activity of macrophages has been studied. It has been shown that Т-lymphocytes of CD27lo are much more effcient activating macrophages and stronger promote formation of active nitrogen forms. Activating action of the effectors of CD27lo was observed even when the ratio of macrophages and T-cells made 625 : 1. With this ratio the active nitrogen forms have not been detected thus one can conclude that there is one more nitrogen independent activation mechanism.

Treatment of multiple drug resistant tuberculosis presents a serious challenge. Use of perchlozon (thioureidoiminomethylpyridini um) in the combination with the other five anti-tuberculosis drugs during 6 months of treatment allowed achieving cessation of bacillary excretion and X-ray improvement in all patients from the main group. Monitoring and evaluation of adverse events have not detected any confident difference in the number of adverse events apart from endocrine and allergic ones while taking perchlozon in the combination with other drugs. All adverse events were minor and moderate as regards severity degree and were managed by symptomatic treatment and did not cause cancellation of the drug. The obtained results will promote achieving the high tuberculosis treatment effciency by the end of the main chemotherapy course and this will require further investigation.

У больных с сочетанной инфекцией на поздних стадиях ВИЧ-инфекции меняется морфология туберкулезного воспаления, приобретающего генерализованный характер, протекая по типу сепсиса с вовлечением 5-6 органов. Клинико-рентгенологические проявления становятся атипичными [3, 5], что приводит к несвоевременной диагностике сочетанной патологии – ВИЧ-инфекция и туберкулез – в 58,3% случаев [6].