THE TABLE OF CONTENTS
THE LIST OF REDUCTIONS................................................................................ 6
INTRODUCTION.........................................................................................................
7CHAPTER 1. THE LITERATURE REVIEW.................................................................... 16
1.1. Epidemiological aspects of a HIV-infection and a tuberculosis..................... 17
1.1.1. Epidemiological aspects of a HIV-infection............... 17
1.1.2. Epidemiological aspects of a tuberculosis, sochetannogo with
HIV-infection................................................................. 20
1.3. Diagnostics of a tuberculosis at children with a HIV-infection................ 29
1.4. Treatment of children sick of a tuberculosis, sochetannym from a HIV - an infection 36
1.5. Preventive maintenance of a tuberculosis at sick HIV-infections of children.................................................. 39
1.5.1. Bacterination....................................................................... 39
1.5.2. Preventive treatment of a latent tubercular infection (tuberculosis chemoprophylaxis) at children......................................................... 45
CHAPTER 2. MATERIALS AND RESEARCH METHODS............................. 52
2.1. The characteristic of a clinical material.................................. 53
2.2. Research methods................................................................ 58
2.3. Statistical data processing............................................ 59
CHAPTER 3. TUBERCULOSIS DIFFUSION, SOCHETANNOGO FROM A HIV - THE INFECTION, AMONG CHILDREN OF 0-14 YEARS IN THE RUSSIAN FEDERATION 62
3.1. Diffusion of a HIV-infection among children of 0-14 years in
The Russian Federation......................................................................................... 64
3.2. Tuberculosis diffusion, sochetannogo with a HIV-infection, among children of 0-14 years......... 71
3.3. Testing of children of 0-14 years sick of a tuberculosis............................................................... 78
On a HIV-infection............................................................................. 78
CHAPTER 4. FEATURES OF THE CLINICAL CURRENT, REVEALING AND DIAGNOSTICS OF THE TUBERCULOSIS AT CHILDREN, SICK HIV - THE INFECTION 82
4.1. Features of a clinical current............................................................. 82
4.1.1. Clinical implications of a tuberculosis at children from a HIV - an infection 82
4.1.2. Radiological implications of a tuberculosis at children from a HIV - an infection......................................... 90
4.1.3. Structure of clinical forms of a tuberculosis at children from a HIV - an infection 96
4.1.4. Complications of tubercular process at children from a HIV - an infection 102
4.2. Features of revealing and diagnostics of a tuberculosis at children with
HIV-infection................................................................................................. 112
4.2.1. Methods of revealing of a tuberculosis at children with a HIV-infection 112
4.2.2. A tuberculinodiagnosis at children sick of a tuberculosis, sochetannym with a HIV-infection.............. 117
4.2.3. Application of allergen tubercular rekombinantnogo for
Revealings and diagnostics of a tuberculosis at children from a HIV - an infection......
1244.2.4. Microbiological diagnostics of a tuberculosis at children, sick HIV-infections 131
CHAPTER 5. OBENNOSTI TUBERCULOSIS CURRENTS, SOCHETANNOGO FROM A HIV -
INFECTION, AT CHILDREN AT DIFFERENT STAGES OF A HIV-INFECTION
AND AT DIFFERENT LEVEL OF MAINTENANCE CD4-KHETOK IN
PERIPHERIC BLOOD.......................................................................... 136
5.1. Features of a current of a tuberculosis, sochetannogo with a HIV-infection,
At early and late stages of a HIV-infection................................................... 136
5.2. Features of a current of a tuberculosis, sochetannogo with a HIV-infection
At different level of the maintenance of CD4-cells in peripheric blood............. 150
CHAPTER 6. CLINICAL IMPLICATIONS OF A HIV-INFECTION AT CHILDREN,
SICK OF THE TUBERCULOSIS, SOCHETANNYM FROM A HIV - THE INFECTION...... 175
6.1. Terms of revealing of a HIV-infection and appointment art.............. 175
6.2. Clinical implications of a HIV-infection................................ 180
CHAPTER 7. THE PREVENTIVE ANTITUBERCULOUS
THE ACTIONS SPENT AT CHILDREN FROM A HIV - THE INFECTION,
ILL WITH THE TUBERCULOSIS................................................................... 195
7.1. Risk factors of disease by a tuberculosis of children with a HIV-infection 195
7.1.1. Absence of bacterination against a tuberculosis.................. 195
7.1.3. Presence of an accompanying pathology............................... 205
7.1.4. Absence of chemoprophylaxis of a tuberculosis in groups
Risk................................................................................. 207
7.1.5. Absence of a dispensary observation......................... 208
7.1.6. Later HIV-infection revealing............................... 209
7.2. Bacterination against a tuberculosis (BTSZH) and its efficiency at
Children born from women, sick HIV-infections............................... 212
7.2.1. Studying of clinical efficiency of bacterination BTSZH in group of children with perinatalnym contact on a HIV-infection
(R75).................................................................................................................... 214
7.2.2. Studying of clinical efficiency of bacterination BTSZH in group of children of sick HIV-infections (В23).............................................................. 219
7.2.3. Immunologic efficiency and safety
Bacterinations BTSZH of children born from sick HIV - by an infection of women 227
7.3. The analysis of data on carrying out of preventive chemotherapy or chemoprophylaxis and its efficiency at children, sick HIV-infections before revealing of a tuberculosis 236
CHAPTER 8. FEATURES OF TREATMENT OF CHILDREN SICK OF THE TUBERCULOSIS
AND A HIV - THE INFECTION.................................................................... 255
8.1 Chemotherapy..................................................................... 256
8.2. antiretrovirusnaja therapy............................................................................................................... 259
8.3. Treatment sick of a tuberculosis, sochetannym from a HIV - an infection in the conditions of children's tubercular unit
SCIENTIFIC RESEARCH INSTITUTE FP............................................................................................................ 263
8.4. Results of treatment sick sochetannoj a pathology.... 269
THE CONCLUSION................................................................................................. 274
DISCUSSION OF THE RECEIVED RESULTS......................................... 278
CONCLUSIONS........................................................................................................... 306
PRACTICAL REFERENCES.......................................................... 309
THE LITERATURE LIST................................................................................ 311
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