2019 № 5 Organizational, clinical and epidemiological approaches in antiretroviral therapy and tuberculosis chemoprophylaxis and tuberculosis incidance among people living with HIV
Antiretroviral therapy continues to play a major role in reducing the spread of tuberculosis among HIV-positive population, especially with chemoprophylaxis of tuberculosis while intensifying systematic screening and fulfilling the requirements of tuberculosis infectious control in places where are staying people living with HIV. In order to assess the availability of antiretroviral therapy and prophylactic treatment of tuberculosis among people living with HIV, and to determine the tendency of the HIV/tuberculosis incidence North-West of Russia, a clinical and epidemiological analysis was conducted from 2007–2017. The analysis was based on data from Rosstat № 61 reporting form on HIV infection and on information from a form which was additionally developed by the author for the territories of the North-West of Russia. Additional information, along with data on the economic and human resources of the system to tackle HIV/tuberculosis issues in the regions, on systematic screening of tuberculosis, includes data on antiretroviral therapy and chemoprophylaxis of tuberculosis among patients with HIV-infection. Results. During the review period, the coverage of HIV-positive antiretroviral therapy increased in Russia more than 10 times, in North-West of Russia) more than 8 times, the availability of tuberculosis chemoprophylaxis increased in Russia in 7.7 times, among people in the proficient stages of HIV-infections – in 2.8 times, in the North-West of Russia – in 16.9 and 4.2 times, respectively. On this background, in the North-West of Russia in recent years there has been a decrease in the incidence of HIV/tuberculosis coinfection from 10.1 per 100 thousand population to 6.6 and 7.3, respectively in 2016 and 2017. Conclusion. In the whole Russia and in the North-West of Russia in recent years, due to the updating or development of new regulatory acts that change organizational, clinical and epidemiological approaches to the treatment of HIV infection and prevention of tuberculosis, the availability of antiretroviral therapy and chemoprophylaxis of tuberculosis has significantly increased among the HIV-positive population. With this background, in the North-West of Russia in recent years there has been a tendency towards a decrease in the HIV/tuberculosis incidence.