The clinical and immunological features of the course of pulmonary tuberculosis (PT) were studied in 418 patients with HIV infection. PT developed in the presence of HIV infection in 212 patients (Group 1), active PT was detected before HIV infection in 72 (Group 2), TB and HIV infection were concurrently diagnosed in 134 patients (Group 3). In the region, most patients with TB and HIV infection were found to have a moderately suppressed immune response. There was a high proportion of patients with disseminated TB in Groups 1 and 3 and those with chronic TB in Groups 2. In Groups 2 and 3, fibrocavernous PT was registered several times more frequently.
Statistics and data on 101 firstly detected children with active tuberculosis in Kemerovo were studied. In 2003 to 2005, there was a marked rise in tuberculosis morbidity among children in the Kemerovo Region, to the utmost in Kemerovo. During a tuberculosis epidemic, a nonfamilial contact mainly with overlooked bacterium-isolating adults plays a leading role in the incidence of tuberculosis. A negligible nonfamilial contact with the registered patients is also of no small importance. Ineffective vaccination increases morbidity rates, in infancy in particular. Timely detection of tuberculosis in adults is the basic way of reducing childhood morbidity.
The study of clinical and X-ray manifestations of the disease in 270 patients has shown that the incidence of disseminated tuberculosis with its acute onset and marked clinical manifestations has greatly increased. It is difficult to make a diagnosis of recently more frequent tuberculosis of the intrathoracic lymph nodes in adults due to acute clinical manifestations resulting from nonspecific inflammation with frequent abscessing at the site of atelectasis in lobar and segmental bronchopulmonary lesions, due to late detection of meagre bacterial isolation, to frequent involvement sites in 3, 4, and 5 segments. Acute generalized disseminated tuberculosis generally follows obscure clinical manifestations from extrapulmonary inflammation in 2-4 months. Acute miliary tuberculosis has frequently accompanied by bacterial isolation and frequently destructions.