доктор медицинских наук;
doctor of medical sciences;
кандидат медицинских наук;
candidate of medical sciences;
Исследование изолятов M.tuberculosis, выделенных от больных ВИЧ-инфекцией, сочетанной с туберкулёзом, свидетельствует о значимом преобладании генотипа Beijing у пациентов Пермского края (ПК) (92,2%) по сравнению с пациентами Иркутской области (ИО) (59,5%), (χ2=1 8,0; p<0,01). Выявлен высокий уровень МЛУ среди ВИЧ-ТБ больных (более 50%); высокая частота случаев микст-генотипов (14,1% – в ПК; 12,7% – в ИО); значительная доля высоковирулентного штамма B0/W148 (34,4% – в ПК; 25,3% – в ИО), что может быть связано с эпидемическим распространением МЛУ туберкулёза среди иммунокомпрометированных лиц.
The population with HIV-infection plays significant role in ongoing tuberculosis pandemic. Immunosup-pression due to HIV-infection is one of the causes of TB disseminated forms in this group of people. Having low immune status is also often associated with a polyclonal M.tuberculosis infection. Aim of the research: comparative assessment of epidemic genotypes of M.tuberculosis prevalence and mixed genotypes identification within HIV-TB co-infected patients in two Russian regions.Materials and methods. The DNAs of 78 clinical isolates from Irkutsk Region (IR) and 64strains from Perm Krai (PK) have been genotyped by MIRU VNTR 24 and RD105/RD207. Strains were obtained from patients who did not have significant age and sex differences. In the PK age of the patients was 34.5±0.9, in IR – 34.4±1.5 years. The samples were obtained from 67.2 and 65.4% of men, respectively.Result. The study of the M.tuberculosis indicates significant predominance of Beijing genotype strains in patients with TB-HIV of PK (92.2%) compared to the IR (59.5%) (χ2=18.0; p<0.01). The prevalence of MDR pathogens in TB-HIV patients exceeded 50%. The mixed genotype detection in the PK and IR was high (14.1 and 12.7% respectively). The level of virulent strains B0/W148 was 34.4% in PK patients and 25.3% in IR ones. Analysis of the results suggests the epidemic spread of MDR-TB in the immunocompromised individuals.Conclusions: The identified trends may indicate that Perm Kray have a process of active dissemination of transmissible strains of M.tuberculosis within HIV-infected population.