The objective of the study is to assess the effect of rs6707530 polymorphism of the FN1 gene and rs1150754 polymorphism of the TNXB gene on the healing of lung tissue destruction in patients with newly detected pulmonary tuberculosis.

Subjects and methods. 82 patients older 18 years with newly diagnosed pulmonary tuberculosis with destruction were enrolled in the study. X-ray data were assessed on the 2nd, 4th and 6th months of the study. Patients were divided into 2 groups depending on the efficacy of chemotherapy intensive phase.

Results. In the group of patients with an effective course of chemotherapy, the frequency of carriers of G allele (p < 0.001) and T/G genotype (p = 0.01) in rs6707530 locus of the FN1 gene was higher. While T/T genotype (p = 0.002) and T allele (p < 0.001) prevailed among the patients with persisting destruction of lung tissue after the intensive phase of chemotherapy.

The issue of rapid phenotypic drug sensitivity testing of clinical isolates of tuberculous mycobacteria remains relevant.

The objective of the study is to develop a new test system for rapid phenotypic drug sensitivity testing of MTB clinical isolates based on lytic mycobacteriophages, capable of testing resistance to first and second line drugs.

Subjects and methods. Cultures of MTB (108 clinical isolates after primary culturing in Bactec MGIT) were incubated for 48 hours with addition of anti-tuberculosis drugs, then for 48 hours more after adding lytic mycobateriophage D29. The subsequent multiplex reaction of the polymerase chain reaction in real time allowed performing quantitative analysis of MTB DNA and mycobacteriophage DNA. The drug sensitivity of the tested sample was assessed by ranges of the differences in fluorescence threshold levels corresponding to the amount of mycobacteriophages between the control and test sample. At the same time, the drug sensitivity/resistance of all MTB clinical isolates after repeated culture was tested by Bactec MGIT which was adopted as a reference method.

Results. Lytic mycobacteriophage-based drug sensitivity testing of 108 MTB isolated to four first line drugs and 90 isolates to six second line anti-tuberculosis drugs demonstrated a high level of concordance with the results of the Bactec MGIT system. It provided 99.5% sensitivity and 100% specificity of the method for 3 first-line drugs; it was slightly lower for ethambutol (86 and 96.9%, respectively), while for second line drugs, its sensitivity made 94.83% and specificity - 98.85%.

The diagnostic accuracy of the artificial intelligence algorithm aimed to detect lesions on low-dose computer tomograms has been independently assessed. The dataset formed as part of the lung cancer screening program in Moscow was used. The following indicators have been defined: sensitivity – 0.817%, specificity – 0.925%, accuracy – 0.860%, area under the characteristic curve – 0.930. High accuracy rates demonstrated through the independent assessment indicate a good reproducibility of the results by artificial intelligence using independent data about the population of Moscow

The objective of the study: to clarify the echo-sonographic semiotics of abdominal tuberculosis.

Subjects and methods. 107 patients at the age from 22 to 58 years old had a sonographic examination and underwent the consequent surgery due to suspected abdominal tuberculosis. 92/107 (85.9%) patients had pulmonary tuberculosis of different severity; 73.9% (68/107) patients pulmonary tuberculosis with concurrent HIV infection.

Results: all patients had ultrasound examinations due to pain abdominal syndrome or clinical signs of ascites. The following echo signs were visualized in patients: enlargement and changes in the structure of intra-abdominal lymph nodes (in 58 patients), changes in the intestinal wall (in 19 patients), heterogeneity of serous membranes and free fluid in the abdominal cavity (in 81 patients). In the absolute majority of patients, there was a combination of those echo signs. Among 107 patients with suspected abdominal tuberculosis, this diagnosis was confirmed in 44 (41.1%), while in 63 (58.9%) patients, non-tuberculosis abdominal lesions were detected: 11 – mycobacteriosis, 5 – lymphopropoliferative disease (lymphoma), and 1 – metastatic lesion of lymph nodes (adenocarcinoma), 3 – colorectal cancer (adenocarcinoma) and in 1 (5.3%) – granulomatous colitis (Crohn disease), 4 – peritoneal carcinomatosis, 1– peritoneal sarcoidosis, 1– peritoneal mycobacteriosis (MAC-infection), in 36 patients – free fluid in the abdominal cavity corresponded to secondary peritonitis caused by perforated tuberculosis bowel ulcers or non-specific ascites against the background of hypoproteinemia or drug-induced hepatitis.

The objective: to evaluate clinical and laboratory parameters in local and generalized forms of Kaposi sarcoma (KS) in HIV infected patients to detect predictors of generalized forms of the disease.

Subjects and methods. Case histories of 58 HIV infected patients with KS at the age from 28 to 80 years old were respectively analyzed; they all received treatment in National Medical Research Center of Phthisiopulmonology and Infectious Diseases of the Russian Ministry of Health in 2018-2020. Cases were divided into 2 groups depending on KS manifestations. LF group (local form of KS, n = 28) included the patients with skin lesions; GF group (generalized form of KS, n = 30) included patients with skin lesions and one or several lesions in the other sites: the mucous membrane of gastrointestinal tract, the mucous membrane of tracheobronchial tree, and lung parenchyma.

Results. Patients with the generalized form of KS had a higher frequency of skin lesions on the body (pχ2 = 0.036), face (pχ2 = 0.033), and multiple sites (pχ2 = 0.018). Patients from both groups had low CD4+ count, but it was more severe in GF group (pχ2 = 0.027) with a significant increase of the viral load (pχ2 = 0.047). The predictors of the generalized form of KS are the following: the presence of specific lesions on the skin of body, face and multiple localizations, CD4 level below 125 cells/mcL, increase in the viral load above 5.3log10 copies/ml, reduction of erythrocytes level below 3.1 × 1012 cells/L. Among 24 patients with KS who had 4-6 predictors, 19 (79.2%) had the generalized form. Among KS patients with not a single predictor, there were no cases of generalized form, as well as there were no cases of local forms among patients who had 5 and 6 predictors.

The objective of the study: to run a multicenter non-interventional observational study to assess treatment outcomes in tuberculosis patients receiving combination drugs with fixed doses, and to evaluate tolerability and safety of these drugs.

Subjects and methods. 13 TB units participated in this study which lasted from 2016 to 2018. The primary population (PP) included of 489 patients, after applying the exclusion criteria – the subpopulation (subPP) included 267 patients with newly detected pulmonary tuberculosis and relapses who received treatment as per chemotherapy regimen I or III. Descriptive statistics methods were used for statistical data processing.

Results. Of all PP, 267 (54.6%) completed the main course of chemotherapy. (subPP). Out of 489 patients, treatment was discontinued in 118 (24.1%) of them. Primary drug resistance was detected in 30 (6.1%) patients out of 489 patients, secondary drug resistance – in 74 (15.1%) of 489. In subPP, by the end of the intensive phase the sputum conversion was achieved in 78 (96.3%) of 81 patients. Clinical and X-ray changes had been observed in this subgroup for 106.2 to 63.3 days (median 90). The duration of the intensive phase in the subPP made 107.9 ± 50.5 days. In safety assessment, 191 adverse events (AE) were registered in 149 (30.5%) of 489 patients. By severity, most AEs were minor (164 out of 191), moderate AEs were less frequent (20 out of 191), and there were 7 cases of serious AEs. 61 AEs in 57 (38.2%) out of 149 patients were confidently associated with in-take of the studied drugs. The structure of those AEs, transient transaminase level elevation prevailed (45 (73.8%) of 61 AEs, but there was a single case (1.6%) drug-induced hepatitis). Among the serious AEs, two cases were safely resolved by the end of the protocol, two of them were fatal in TB/HIV co-infection, and three cases were diagnosed with cancer.

Foreign bodies in the respiratory tract are rare in adults. Clinical manifestations include hemoptysis among other signs which requires the examination to detect tuberculosis and lung cancer. The article describes a clinical case that demonstrates the possibilities of endoscopic diagnostics and treatment in the patient with an X-ray negative foreign body (a cigarette filter) that has been in the lumen of the upper lobar bronchus of the right lung for a long time which caused inflammation in the blocked lobe and mimicking endoscopically central lung cancer.

The article presents the review of 94 publications. It describes experiments on latent tuberculosis infection on Cynomolgus macaques. It has been noted that in recent years, PET-CT has been used to identify thoracic lymph nodes (LN) infected with Mycobacterium tuberculosis (MTB). It has been demonstrated that FDG-PET-CT allows concluding about the presence of viable MTB in thoracic LNs in case of latent tuberculosis infection which is confirmed by detection of live MTB in granulomas of these LNs by culture. The preventive therapy contributes to a significant reduction of pathology visible on PET-CT. The review analyzes publications that experimentally show the spectrum of the immune response to MTB-specific proteins ESAT-6 and CFP10 in case of tuberculosis infection, in particular, the relationship between the cytokine response and bacterial load.