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THE TABLE OF CONTENTS

THE LIST OF REDUCTIONS................................................................................ 6

INTRODUCTION.........................................................................................................

7

CHAPTER 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......

124

4.2.4. 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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Scientific source KLEVNO HOPE IVANOVNA. TUBERCULOSIS At CHILDREN, SICK HIV-INFECTIONS (prevalence, features of clinical implications, diagnostics, treatment, preventive maintenance). The dissertation on competition of a scientific degree of the doctor of medical sciences. Moscow - 2015. 2015

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