The objective of the study is to analyze TB/HIV co-infection situation in the regions of RF and to identify correlated epidemiological rates.
Subjects and methods. The data from Rosstat Forms no. 61, 8 and 33 were used as well as Rosstat data on the number of population for 2017.
The data reflecting the structure of the patients with TB/HIV co-infection were obtained from Rosstat Form no. 61 for 2017.
In order to define correlations between the rates characterizing the population of tuberculosis patients and patients with TB/HIV co-infection, the correlation analysis was performed (the standard tools of Statistica software).
Results of the study. In Russia, TB/HIV co-infection was not equally prevalent and it was the highest in 35 regions of Russia. According to the results of correlation analysis, in 37 RF regions with a low level of TB/HIV co-infection (< 7% of the total number of tuberculosis patients), tuberculosis mortality during the 1st year of follow-up depended on the prevalence of multiple drug resistant tuberculosis (MDR TB) among all tuberculosis patients. In 48 Russian regions with a high level of TB/HIV co-infection (≥ 7% of the total number of tuberculosis patients), the prevalence of MDR TB and mortality in the patients within the 1st year of follow up directly depended on the prevalence of this co-infection. In 16 Russian regions, where the portion of new cases with concurrent MDR TB made from 23 to 60%, the risk of lethal outcome was the highest. The co-morbidity with hepatitis was observed in 42% of new cases of co-infection and in 43% of all those being followed-up. 

The objective of the study: to investigate the effectiveness of real-time PCR for express drug susceptibility testing in drug resistant pulmonary tuberculosis patients using sputum samples and specimens of lung tissue collected during surgery.
Subjects and methods. 231 sputum samples and 240 biopsy specimens collected during surgery were tested with the use of real-time PCR and multi-competitive allele-specific real-time PCR.
Results: the positive results of testing for MTB DNA were obtained in 72.7% of respiratory samples, of which in 61.9%, the number of genomic DNA copies was sufficient for drug susceptibility testing; positive results were observed in 93.3% of biopsy specimens, and in 93% of them the drug resistance of tuberculous mycobacteria was tested. The difference in the effectiveness of drug susceptibility testing of biopsy specimens and respiratory samples was statistically significant: p < 0.01. When testing respiratory samples, multiple drug resistance (MDR) was detected in 42.3% of cases, and when testing biopsy specimens, MDR was detected in 34.4% of cases. The high effectiveness of real-time PCR and multi-competitive allele-specific real-time PCR was demonstrated when testing biopsy specimens and performing express drug susceptibility testing in tuberculosis patients after surgical treatment.

The objective of the study: to identify specific features of tuberculosis of the sternum and ribs in children using data of CT scans.
Subjects and methods. 16 children at the age from 1 to 8 years old with bacteriologically confirmed tuberculous ostitis of the sternum or ribs or perichondritis of the ribs were followed up; from 2013 to 2015, all of them had surgery in the pediatric surgical clinic of St. Petersburg Research Institute of Phthisiopulmonology. The scans of their computed tomographies performed not earlier than 2 weeks before the surgery were analyzed.
Results of the study. Tuberculous ostitis of the sternum and ribs in children is usually characterized by the presence of an extensive destructive cavity with the destruction of the cortical layer and dissemination into soft tissues (clinical examples are given). 
Sclerosis, swelling of the bone in the affected area, free bone sequestration in the destructive cavity and surrounding soft tissues, described in the literature as typical signs of tuberculous bone lesions, are not often found in tuberculous ostitis of the sternum and ribs in children. 

A retrospective cohort study of postponed outcomes of surgical treatment of patients with pulmonary tuberculosis was conducted; all patients lived in the region with a high prevalence of the disease (the Republic of Altai) and were treated during the period from 2004 to 2014. All patients (n = 215) had indications for surgical treatment. The main group included 111 patients who underwent surgery further on, while the comparison group included 104 patients who rejected the proposed surgery for various reasons. Outcomes were analyzed in 3-9 years after indications for surgical treatment were identified, depending on the clinical form of tuberculosis and type of surgical intervention. It was found that the lung resection as a part of the comprehensive treatment of patients with pulmonary tuberculomas allowed achieving clinical cure in a confidently bigger number of cases (97.1%) compared to those who rejected surgical treatment (80.0%, p = 0.003; χ2). Clinical cure after resections due to fibrous cavernous tuberculosis was achieved in 90.0% of patients, and only in 44.4% of those who refused surgical treatment (p = 0.02; two-sided Fischer’s Exact test). Collapse surgery allowed achieving clinical cure in 62.5% of cases with disseminated fibrous cavernous pulmonary tuberculosis, while conservative treatment provided clinical cure only in 8.6% of cases (p = 0.0001; two sided Fischer’s Exact test); the mortality made 6.3 and 42.8%, respectively (p = 0.01; two-sided Fischer’s Exact test). 

The objective of the study: to compare the state of mucociliary clearance and bronchial ciliated epithelium in smokers and non-smokers suffering from chronic bronchitis.
Subjects and methods. 80 chronic bronchitis patients with exacerbation were examined; they were divided into 2 groups: Group 1 included 40 active smokers and Group 2 comprised of 40 patients who had never smoked. The comparison group included 10 non-smokers with no respiratory disorders. All chronic bronchitis patients had certain examinations including bronchoscopy with biopsy and consequent ultrastructural tests of biopsy specimens and aerosol scintigraphy of the lungs for mucociliary clearance assessment.
Results. Morphological and functional changes in the mucociliary transport system were detected in case of chronic bronchitis versus those healthy. Those changes were more profound in the smokers compared to non-smokers. Thus, the smokers with chronic bronchitis were diagnosed with a significant reduction of mucociliary clearance corresponding to degree II of mucociliary transport system failure, which was down to 16.60 ± 2.40% (down to 23.91 ± 2,11% in non-smokers, while it was 34.82 ± 2.14% in health) with concurrent diffuse bilateral bronchitis deformans and significant amount of very viscous mucosal or mucopurulent discharge according to the endoscopy data. The ultrastructural testing of biopsy specimens detected the significant damage of bronchial ciliated epithelium in the form of diffuse atrophy, focal metaplasia, which was one of the obvious causes of significant impairment of mucociliary transport. 

Surgical specimens collected from 13 cases of destructive pulmonary tuberculosis were retrospectively analyzed; for at least 3 months in the pre-operative period, all of them received peribronchial lymphotropic therapy or inhalations with anti-tuberculosis drugs due to inflammatory changes in the bronchi. All patients underwent lung resection on the level of the main or lobar bronchus. During inhalations with anti-tuberculosis drugs, the pathomorphological tests showed profound dystrophy of ciliated epithelium of bronchial mucosal membrane and significant thickening of basement membrane. While in the group treated with peribronchial lymphotropic therapy such changes were minimal or absent at all (p < 0.001). It was concluded that peribronchial lymphotropic therapy was a modern highly effective treatment method within comprehensive preparation for surgery in destructive pulmonary tuberculosis patients with multiple or extensive drug resistance and endobronchitis as a complication.

Anti-tuberculosis chemotherapy makes a main component of therapy and involves the long-term treatment with the optimal combination of drugs. Tuberculosis incidence has been noted to be high in the risk groups (those receiving immunosuppressive therapy, people living with HIV, etc.); such patients are treated for their main disease in addition to anti-tuberculosis chemotherapy. A large number of drugs used simultaneously in treatment regimens can reduce patient's adherence to treatment, deteriorate drug tolerance and increase the frequency of adverse reactions. Using slow-release drugs within treatment regimens is one of the ways to reduce polypragmasy. One of them is rifapentine, recommended in the Russian Federation for the treatment of latent tuberculosis infection in patients with HIV infection.
The review presents information about the efficacy, tolerability and safety of rifapentine within treatment regimens for active and latent tuberculosis infection.