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Puck tyGepkyaesa cpemm BHY-nndprimposaninix HILHBILAYYMOB B sHAMUTesIBHOM crenenH saBHeHT of pacnpoctpanentocta TyGepkyaésa 8 nonyas- ust [10] Anas Teiaenunit TyGepKytesa Ha r0GaTb- HoM ypontte, smoatent ET, KopGertos 1 co- asropamn [13], nporemorterpxpowan snares 0 reorpaipisleckyIo BapHaGerBHOCTI: B HacTO- Te TySepxyaésa epean BHMY-uiutmponartinix anentos. Xora nportopuss Ko-1IxpHLUMpOBAREBIX HHLTHBNAYYMOD HOKE B AgHH, YeM B AdpniKe, a6- ComoTHOe KOTHICCTHO KO-MHILHpORALENX HL 61(XA) Becrank ArMB Ne 1-2, 2015 THB npessiuaer 2 wax, B HiaHH, HanpaMep, TOKO 3.4% ryGepkynésa ceasaHo © BHY, Ho Hxaus ropas erpaia nocae IOauioll Adppuxit, no aco- JMOTHOMY KOTHIECTAY KO-HHIDELPOBARHEIX HEI- sietyywos. Mporosupyeres, sro 8 Mamet omme- sia BH npusener « noasaennto sonore unx 200 TEIC. cay'taen TyGepKyaésa B rox [14]. Hierores no xpaiieli mepe 4 cbaxropa, Ko- ‘Topwie nosstelicrayior Ha saGoseBaemocTs, TyGep- Kyou: 1) pacnpoctpanentocts nareHTHoit widextun Mycobacterium tuberculosis # nonyasiuii, K KOTO- poli oTHocHTeR aaHHBIit Her0BeK; 2) nepostnocr xowraxra © ‘apasnnsiM. mal ento; 3) erenen® uwyxiocynpecenm; 4) ucnomssonanne npopusaxtuseckoii Tepa- snus (aeseue aateHTHoll uiupexust). Kaiowesiia noxasarestem, koropsili: mpucyr- evmyer BO Bcex THX dhakTopax, sBaeTeR cTe- renb, € KoTopofi amma, mx pmnmponamsre BUY 1 TyGepryaésom, Haxoaater B omHO!i Toit we Ipynne 11H omnoit a ToH ~e NOnyasmuN. HanpH- Mep, MOTpeOHTEAH HHBEKINONETBIX. WapKOTIIKOR MOryT UMeTS Gouee BbICOKYO acrory KoHTaKTa © SapasHIMH nanHeHTawH, a TaKKE C Gosbinedi BeposTHOcTHIO GuiTh Hixbunuponarisiv BEY. Ha rioGazsHiom yposie cyutecrayior axa Tesbubie TeorpadusieckHe pasansiis 8 pacnpocr- panennocrn BUY mpextum cpeam namnenron © ryGepxyné30m, Pacnpoerpanenmocrs BHM y ma- uneHTOR © TyGepKysI630M KOppemMpyer € HonysIs- UMoHHOHL NacToTOH H Rapbupyer oF 1% B 3anaa- Ho-TuxooKeaxekom perHone 10 14% B myer PHaIHO paIBHTHNX crpaHax H 38% m ApuKe [13]. B JOacoiit Adppuxe, rae pacnpocrpasienHocre BHY npessimaer 20%, cnsime 60% nanverton ce TyGepxysiésom TaxsKe Haxsnponantst BAY [17]. Bo neem mupe 13% acex ewepreli or tyGepKy- asa BOSHMKaeT ¥ KO-HHDHUMpOBAHHBIX MaUKeH- TOR ¢ cyMMAPHEIM nOKazaTeseM sleraTbHOCTH 40 % aaa BHY-nabunmponannsnx caysaes TyGep- xyrésa, Meary pasnsivit cTpanaui cymectayer suavmTembitan BapHaGeNbHOCTE B CMEpTHOCTH OT ryGepxyaésa ~ or 9 na 100 Toc. m past 20 139 p lOnnoit Apune, sro Momer Osrrs oFpxC- HeHo patina 8 vactore ushunupoRaHHs BH 13] BHY spseres HaGonee cHLtbHbiM 1 HIRE emmbix aktopos pucka pasauTua tTyGepxyaéa, YY Gonbumicrea vMyHoKOMMeTeHTHEIX. HHAMBI- ayyMon, 1 x Mycobacterium 62 tuberculosis, Gakrepun Haxoasres 8 s18rowsix Npanyiemax, TO MpHBOAHT K JaTeHTHO! TyGep- xyuesHolt uHexunn. JlateHTHas TyGepKyaésHas maeKuHa — 970 ACHMMTOMATHMECKAR HHKbeKUA © HeGombMMMM GannaaapHEIM sHcTOM, KOTOpaR caepanpaerca HMMyHHOli peaxuneli opranisma xosaitia, Tydepryés passumaeres anG0 3a exer npo- rpeccuposaHisi HezaBHO MpHoGpeTeHHOMK uineK- MH, s1HO 3a cuer peaxrHRAMIMH areHTHOTO Ty- Gepxynésa. B perwonax ¢ Hi3KoHi pacnpocrpanien- HOCTHIO TyGepkynésa Mpeanoaraeres, 170 Gomb- laa HacTH Cay4aeR sBARETCR CIEACTBHEM sa- TenTHOH mmiextuM, NocKOTBKY BosHNKAeT xpafine neGoamoe KomMHECTBO HoBLIX cayHaEB mNEK- nut [17]. Puck saGorenanis rioese uexpuumpona- itz Mycobacterium tuberculosis pesko yaenmun- maeres y naumeHTos ¢ BUY Ko-mibexuneli — or 10% Ha npormxeHMH AHSHH y HMMyHOKOMTETEH- ‘THOTO XosantHa 10 10 % B ron ¥ KO-MXMUINpOBAH- noro nannenra [3]. 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Yoemmersian syecrarrrenbHocT mipmMpoBaHABIX BMY nannentos x mupexum Mycobacterium tuberculosis Gsietpoe nporpeccnposanne aKtin- HOTO 3aG0NERAHHA MOryT YCHTMBATE pacnpoct- pAHEHHE pesHCTEHTHEIX urTaMos. Bostee Toro, OGUIME oTHAEMHOTOrHHECKHE (bakTOPH pHcKa mammmpovanna BHY a MJIY TB, Taxne, Kax HcTIOABSOBAHHE TOTPEGTCHHA HHTBEKUMOHHBIX Hap- KOTHKOB H TocmHTaaHsams, cnocoBernyIOT yne-Pagnen |. Knusineckie acnekrel sapascoxpaHeHia Cel ansientiofi pacnpoctpartentiocr MJIY TB y BUY ‘max muuponantix HuznBuryyMos [5,8]. Tipermecrayromas Tepani TyGepKyesa 38- ARETCA CHABUBIN. dbaKTOPOM pasBHTHA TyGEpKY- eva © MHOKecTReHHOH TeKapcrBerttoit yeroFiem- BOCTEIO BHIE saBMeHMOCTHE OT BHY craryea. 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B nectezoBanis, mposemeHHiom 1 Tanaanze [13,15], pacnpoctpartenttocts tyGep- Kyresa ¢ mioxecTRenttoit TeKapeTaeHtHoit yeroii- anpocTHIO Gpiza sHasrTeabHO BEANE y BHY-n- qpuumposanntrx ranmerto8 Ges mpeamieeraytomteti ryGepkysésHoH| Tepanun, No cpaBHetHHo ¢ BUM orprtarestonbinir HizHBHAYysanat (5.2% npoTHE 0.4%). BUY-nnbuimposannsie sma © Gombatelt epoRTHOCTSIO HMeTH Ayre smmtTeNHOTOTHIeC- Kite cbaxropst prteKa TyGepKyaésa, a MMento Gores HHsKHIt ConMaTDHO-—sKOHOMMHECKH cTaTye WM NOTPEGACHHE HHGEKINONHBIX HapKOTHKOB. B Jlume 8 Mepy MJIY TB Gur oGtapyxen y 43.% BUY-unuumposanmnx wy 3,9 % manent Tos, He mdutmposanntix BUY. TyGepxyaés © MHOKecTBeHHOM TeKapeTReHKOH ycToItsHBOCTEIO y BHY-nix)mumponannirx nanventtos He O13 coa- san ¢ npemmrectayiomtel! Tepanneii, xo BHY-nn- dbmunposannste nanerrrst ¢ TyGepKyEOM TeMON- etpmposaan Goabmyto HactoTy nocemenns Kan- HK, 47 MOFIO YRCAINSHBATE REpOTHOCTI HX KOH- Takra c sapasnoimn nanvenrant [9,16]. 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Pexomenra- I MOTyT BHEApATECA NporpaNMantH No GopsGe c BHY i TyGepxyaésom nenpanirerecTaeHHBiN oprannsannant, oGmecrseHtibiMe OprattsanitaNt Han HaCTHBIM ceKTOpOM c OGIIEM HaGMOTEHTEM co cToporta HanrorambuEMX MporpamM. no GopKGe © BUY 1 ryGepKyaésom. 63[XYKTEIPFAH Hayka- crapabin enimexiriainix xoraps! Gonybina axenin coragtl xeNe Bencenai TyGepryneare apwly KayniN ApTTapAa >Kacsipbit TyGeprynesi Gap 2 Munnvapa anaMaapabiK GackiM Kenwiniri AMTB2xyKnace! xkacEIOBH TyGepKyNESA .xanni TyBeprynes aypybinik amy! Yin KOnainb| xaraaitTyABpaTeis, ATE inpleTi reKiKeH TapanraH eKjonepne feuip cypeni. TySepKynesGeH aybiparbin anammapMeH canbicTHipraHja Ko-NHEpeKUMACEIK XYKTHIPFAH HayKacTap- ‘AUN enyinix xorapbi Borys! wiyruin epuyAin cangapbIvan TyuINAAARGI. Cou enim KarAalinapbiNtn GacuiM Geni feugeny HeMece Tepanwiarlul anraulKh: alinapts Gacranrak Kegge opbiN anagui. AVITE inugeTin xyKTaIpraH Kayka- ctapna Ty6epxynesni emaey papinix rypanaapaen Kepi acep eTyi HeMece MAMyHALK xyMIeHi KanneiHa KenTipy cimapombl, conaii-ak oneyMeTTix-skoHoMKanbiK Keneprinep CHAKTE! GHONOrHANEIK aKTOpnapMeH KyPAeneHe rycen ‘TyGeprynesGen xaHe AMTB-MeH Kypec xyieciKiK KoNAaNLICTarLI MKcppaKyDLINEIME! linge eKi eo >YKTEK pybika Garbirranran Gini Gopy xeHe Anakin any GarAapnamanapun KOKeITY OCH chipKaTTApALK aybipnUrLiN Tomenaeryain anrawns! Kaname: Gombin TaGsnagel. AMTB ingeTin xyKTEIpraH TynFanapAem apacuinaa TyGepKy- eagi akbiKTayAb! KaKcapry, cOnMalI-aK TyGepKynesre WaTAbiKKAH HayKacTapabik Gapribrbina AVTB-Ha TexKcep- 64Pagnen |. Knusineckie acnekrel sapascoxpaHeHia el lnyit youny Mek KoHlec Gepy ANTB Men TySeprynes IneTIKIN Tapanysina KapCH TYpYAMIK Herr! KagaMe! Gonkin Tabuinaass ‘Tyilinai coanep: TyBepiynes, AMITB, Ko-HicbexuMA, onuAeMMonoris, argeiH any. ‘SUMMARY HIV infection accelerates the course of tuberculosis, resulting in higher mortality in co-infected patients and Increases the risk of progression to active TB. A large number of the 2 billion people with latent tuberculosis, living in regions with high HIV prevalence, where HIV infection tums latent tuberculosis in a time bomb for the development of tuberculosis in general. As a consequence of rapid progression, mortality is significantly higher in co-infected patients, compared with those who only have tuberculosis. Most of these deaths occur before treatment begins, or during the early months of therapy. In HIV-infected patients TB treatment is often complicated by biological factors, such as the side effects of drugs or immune reconstitution syndrome, as well as socio- economic. barriers, Expanding education and prevention programs aimed at dual infection within the existing infrastructure systems to combat tuberculosis and HIV is an inital step to reduce the load of these diseases. The main step In response to the overlapping epidemics of HIV and tuberculosis is to improve the detection of tuberculosis among people living with HIV, as well as the provision of HIV testing and counseling to all patients with tuberculosis. Key words: tuberculosis, HIV co-infection, epidemiology, prevention. 65