Multidrug-resistant tuberculosis in patients with HIV infection in the CIS countries


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Abstract

Objective. To study changes in the indicators of test coverage, prevalence, and successful treatment of multidrug-resistant tuberculosis (MDR-TB) among HIV-infected patients in the CIS countries in the period of2010-2018. Materials and methods. Epidemiological data were analyzed in the Republic of Azerbaijan, the Republic of Armenia, the Republic of Belarus, the Kyrgyz Republic, the Republic of Tajikistan, and the Vladimir Region of the Russian Federation. The data sources were national cases databases, state data registers, departmental statistical reports, the data of phthisiological services and state statistical services, as well as regular reports submitted by the countries to the WHO and UNAIDS. Results. The cumulative assessment of changes in the number of all registered cases in the countries over the period of 2010-2018 suggests that there may be an increase in the number of patients with MDR-TB. During the study period, the coverage of the population by drug susceptibility testing (DST) for the pathogen gradually increased; however, the rate of coverage growth did not always correspond to the increase in the absolute number of incident MDR-TB cases. As this took place, DST was carried out for all incident TB cases in the Republic of Belarus and in the Vladimir Region. A comparison of HIV/TB cases and all TB cases showed that the pathogen resistance as a minimum to rifampicin (RR-TB) was more common in patients with HIV/TB co-infection. The success rates of MDR-TB treatment in HIV-infected patients still significantly lag behind those in drug-susceptible TB (DS-TB) and show no considerable changes during the follow-up period. Conclusion. The detailed analysis of the prevalence of MDR-TB among the people living with HIV is of great prognostic importance for assessing the epidemic situation as a whole, calculating the funding of TB control programs, and improving the control over the disease and the eff iciency of treatment.

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About the authors

Vera N. Zimina

Peoples’ Friendship University of Russia

Email: vera-zim@yandex.ru
MD, Professor of the Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute

Alexey V. Kravchenko

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: alexey-kravtchenko@yandex.ru
MD, Leading Researcher

Ekaterina I. Kulabukhova

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Peoples' Friendship University of Russia

Email: ekulabukhova@mail.ru
Infectiologist

Zoya K. Suvorova

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: zksu@inbox.ru
Cand. Biol. Sci., Senior Researcher

Anastasia V. Pokrovskaya

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: pokrovskaya_av@mail.ru
Cand. Med. Sci., Senior Researcher

Olga N. Khokhlova

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: x.olia79@mail.ru
Cand. Med. Sci., Researcher

Olga O. Vinokurova

Peoples’ Friendship University of Russia

Email: olga.berejnaya12@gmail.com
Cand. Med. Sti., Assistant Professor, Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute

Ekaterina A. Li

Center for Advanced Technologies in Healthcare

Email: kh.yekaterina@gmail.com
Head, Research Program Supervisor

Agigat A.-K. Kadyrova

Research Institute of Lung Diseases, Ministry of Health of the Azerbaijan Republic

Email: dr.kadyrovah@mail.ru
MD, Director

Arshak S. Papoyan

Republican Center «ASTGHIK»

Email: arshak.papoyan1@gmail.com
Epidemiologist

Ruben A. Oganisyan

Professor R.H. Yeolyan Haematology Center

Email: ruben.hovhannisyan77@gmail.com
Epidemiologist

Viktoryia Ya. Kralko

Republican Scientific and Practical Center of Pulmonology and Phthisiology

Email: kralko2017@gmail.com
Deputy Director for Organizational and Methodological Work

D. A Klimuk

Republican Scientific and Practical Center of Pulmonology and Phthisiology

Email: dzklm99@yahoo.com
Department of the Phthisiopulmonological Monitoring and Evaluation

Aibek A. Bekbolotov

Ministry of Health of the Kyrgyz Republic

Email: aibek_0001@mail.ru
Deputy Director, Republican AIDS Center

Elvira D. Abdrakhmanova

National Center of Phthisiology, Ministry of Health of the Kyrgyz Republic

Email: elmiraa1@yandex.ru
Head, Department of Informatics and Epidemiology

Alijon A. Soliev

Republican Center for AIDS Prevention and Control, Ministry of Health and Social Protection of the Population of the Republic of Tajikistan

Email: salijon@mail.ru
Cand. Med. Sci., Deputy Director

Shahnoza A. A’zamova

Republican Center for the Protection of the Population from Tuberculosis

Email: azamova.shahnoza@mail.ru
Deputy Director

Grigoriy V. Volchenkov

Centre for Specialised Phthisiopulmonological Care

Email: root@tubdisp.elcom.ru
Chief Physician

Tatyana N. Zamkovaya

Regional Center for the Prevention and Control ofAIDS, Vladimir Regional Clinical Hospital

Email: aids.doctor@yandex.ru
Head

Vadim V. Pokrovsky

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: pokrovsky.vad@yandex.ru
Academician of the Russian Academy of Sciences, MD, Head, HIV Department

References

  1. WHO. Global Tuberculosis Report, 2020. https://www.who.int/teams/global-tuberculosis-programme/tb-reports
  2. Laurence Y.V., Griffiths U.K., Vassall A. Costs to Health Services and the Patient of Treating Tuberculosis: A Systematic Literature Review. Pharmacoeconomics 2015; 33(9): 939-55. doi: 10.1007/s40273-015-0279-6; PMID: 25939501; PMCID: PMC4559093
  3. WHO. Global Tuberculosis Report, 2018. https://www.who.int/teams/global-tuberculosis-programme/tb-reports
  4. Sultana Z.Z., Hoque F.U., Beyene J., Akhlak-Ul-Islam M., Khan M.H.R., Ahmed S. et al. HIV infection and multidrug resistant tuberculosis: a systematic review and meta-analysis. BMC Infect. Dis. 2021; 21(1): 51. doi: 10.1186/s12879-020-05749-2. Erratum in: BMC Infect Dis. 2021 Jan 20; 21(1): 86. PMID: 33430786; PMCID: PMC7802168
  5. WHO operational handbook on tuberculosis: module 4: treatment: drug-resistant tuberculosis treatment (2020). https://www.who.int/publications/i/item/9789240007048
  6. WHO. Definitions and reporting framework for tuberculosis - 2013 revision. Geneva, Switzerland: Wolters Kluwer Health, 2013. 40 p.

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