"CTRI Bulletin"

CTRI BULLETIN №1 (10) 2020

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Chief Editor: Ergeshov A.E.
Year of foundation: 2017
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Publisher site: http://critub.ru



The impact of mdr associated proteins of lung cells on reducing effectiveness of tb drugs

Erokhina M.V., Lepekha L.N.


The results of financial monitoring of TB control activities and main funds of TB organizations in the Russian Federation in 2018

Sterlikov S.A., Rusakova L.I.


Herpesvirus infections in TB patients

Shibanov A.M., Stakhanov V.A., Karazhas N.V., Sobkin A.L., Boshyan R.E.


Clinical features and treatment efficacy in isoniazid-resistant pulmonary TB patients with additional MTB resistance to other drugs

Zakharov A.V.


Radiological semiotics of pulmonary TB in patients with end-stage kidney disease

Gordeeva O.M., Karpina N.L., Amansakhedov R.B., Mikhailov S.G.


The impact of antiretroviral therapy on the effectiveness of HIV/TB co-infection treatment based on the lipid spectrum rates

Makarov P.V.


The hemostasis system state and morphological changes in the pulmonary microcirculation in TB patients with concomitant diabetes mellitus depending on the scope of lung surgery

Serebryanaya B.A., Lepekha L.N., Abdullaev R.Yu., Chitorelidze G.V., Berezovsky Yu.S., Nikitin S.S., Bagirov M.A.


А case of generalized tuberculosis in a patient with HIV infection

Bayke E.E., Rogova O.O., Arkhipova M.V.


The principles for preparation of diagnostic samples for microbiological detection of mycobacteria

Sevastyanova E.V., Larionova E.E., Andrievskaya I.Yu., Smirnova T.G.


About the conference, dedicated to the 100th anniversary of Children and Adolescetns’ Clinic, CTRI

Ovsyankina E.S., Gubkina M.Ph., Panova L.V., Yukhhimenko N.V.


To the 75th anniversary of Evgeny Ivanovich Shmelev



Article 1.Page 5.


DOI: 10.7868/S258766782001001X


Erokhina M.V.1,2, Lepekha L.N.1

1 Central TB Research Institute, Moscow, Russia

2 M.V. Lomonosov Moscow State University, Moscow, Russia


Submitted as of 26.11.2019

The article reviews issues related to the development of multidrug resistance (MDR) of somatic cells in macroorganisms, which results in reducing effectiveness of TB drugs, including rifampicin. We highlight the history of resistance development and ways to overcome it in cancer patients. We survey the main transporter proteins responsible for delivery of drugs or other substrates across cell membranes. The most universal transporter is P-glycoprotein (Pgp) with the widest range of substrates; it provides the highest levels of MDR somatic cells and predicts a negative outcome of cancer. The article gives the examples of the first foreign and Russian publications related to increasing gene expression of MDR associated somatic cell proteins in the experiment, in clinical pulmonary TB, and under TB treatment. TB drugs are considered as modulators of endocytosis and activity of MDR associated proteins. We hypothesize that there could be synergism between M. tuberculosis ATP-binding transporters and a host’s MDR somatic cells.

The article was prepared under basic research topic no. 0515-2019-0015 “The development of drug resistance of mycobacteria and somatic cells to TB drugs”.

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Central TB Research Institute

2, Yauzskaya alley, 107564, Moscow, Russia

M.V. Lomonosov Moscow State University

1, Building 12, Leninskie Gory, 119991, Moscow, Russia

Maria V. Erokhina, Doctor of Biological Sciences, Senior Researcher, Department of Pathomorphology,

Cell Biology and Biochemistry, Central TB Research Institute; Docent, Cell Biology and Histology

Department, Biology Faculty, M.V. Lomonosov Moscow State University

Tel.: +7 (499) 939-45-67

E-mail: masha.erokhina@gmail.com

Central TB Research Institute

2, Yauzskaya alley, 107564, Moscow, Russia

Larisa N. Lepekha, Doctor of Biological Sciences, Acting Principal Researcher, Professor, Head

of Department of Pathomorphology, Cell Biology and Biochemistry

Tel.: +7 (499) 785-91-79

E-mail: lep3@yandex.ru


Article 2.Page 21.


DOI: 10.7868/S2587667820010021


Sterlikov S.A.1,2, Rusakova L.I.2

1 Central Research Institute of Organization and Informatization of Health, Moscow, Russia

2 Central TB Research Institute, Moscow, Russia


Submitted as of 02.12.2019

Aim: To revise the methods of calculation of per capita funding rates related to TB control activities, and monitor the rates related to funding of TB control activities and the state of main funds of TB institutions. Based on a single statistical observation form, we analyzed the rates of dynamic funding of TB control activities from different sources, the state and the update of the main funds of TB institutions. The total amount of funding was compared to the data from different countries provided by the WHO global database. The amount of funding for TB control activities in the Russian Federation was 94.5–93.1 billion roubles, or 1450.7 billion USD, which was more than in any other country. This allowed rapid reduction of TB incidence. The inclusion of antiretroviral drugs in the calculation of per capita funding rates in some Russian regions accounted for a 3–5% error. The methods currently used for per capita funding calculation did not consider discrepancies in medical care costs in different regions, which made an illusion of favourable funding of the Far East regions. In 2018 we observed unprecedented growth of salaries and other payments to health personnel, especially physicians. At the same time, updating of the main funds decreased resulting in the wear of equipment and vehicles. The share of TB control activities funding by the Russian Federation Subjects increased, since they were responsible for payments to health personnel. In order to harmonize the Russian and international definitions of the rate: “funding of TB control activities”, it was recommended to introduce a system of financial monitoring of TB control activities without consideration of antiretroviral drugs, since it had resulted in overestimating TB control activities funding in the Russian Federation by 1.8%. The calculation of per capita funding rates by the Russian Federation Subjects should use the differentiation coefficient. Underfunding of updating the main funds of TB institutions resulted in high wear of equipment and vehicles, which could negatively influence TB control in general.

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  6. Tokun L.V. Investments as a factor of sustainable Russian health care. MIR, 2016, vol. 2, no. 7, pp. 132–138. (In Russ.) doi: 10.18184/2079-4665.2016.
  7. Global tuberculosis report 2017. Geneva, WHO, 2018, 249 p.
  8. Global tuberculosis report 2018. Geneva, WHO, 2018, 265 p.
  9. WHO’s global tuberculosis database [Electronic resource]. Mode of access: https://www.who.int/tb/country/data/download/en/ (date of referral:28.10.19)

funding of TB control activities, financial burden due to TB, funding sources for TB control, state of TB institutions, main funds, depreciation of main funds of TB institutions.


Central Research Institute of Organization and Informatization of Health

Dobrolyubova St., 127254, Moscow, Russia

Sergey A. Sterlikov, Deputy Head, TB Monitoring Center for Program Monitoring, Doctor of Medical


Тел.: +7 (925) 507-82-21

E-mail: sterlikov@list.ru

Central TB Research Institute

Yauzskaya alley, 107564, Moscow, Russia

Larisa I. Rusakova, Principal Researcher, Head, Research Administration Department, Doctor of Medical


Tel.: +7 (499) 785-91-87

E-mail: larisa.rusakova@mail.ru


Article 3.Page 30.


DOI: 10.7868/S2587667820010033


Shibanov A.M.1, Stakhanov V.A.2, Karazhas N.V.3, Sobkin A.L.1, Boshyan R.E.3,4

1 TB Clinical Hospital No. 3 named after Prof. G.A. Zakharyin, Moscow, Russia

2 Russian National Research Medical University named after N.I. Pirogov, Moscow, Russia

3 N.F. Gamaleya Research Institute of Epidemiology and Microbiology, Moscow. Russia

4 First Moscow State Medical University named after I.M. Sechenov, Moscow, Russia


Submitted as of 05.12.2019

Aim: To study the peculiarities of TB process in herpesvirus infection (HVI) patients with a negative or positive HIV status. Materials and methods. We carried out a pilot case-control study of 350 TB patients. To establish a possible cause of acute TB progression, we studied patients’ blood sera and cells for opportunistic infection markers to detect antibodies to herpesviruses and their antigens. Results. The high level of infection (up to 97%) was established in both HIV-positive and HIV-negative TB patients. We discovered the association between drug resistance of M. tuberculosis and HVI activity markers. Conclusion. Patients with advanced pulmonary TB and detected markers of HVI activity should undergo additional examinations, and patients with confirmed HVI should be considered for administration of antiviral drugs.

  1. Human herpesvirus infections. Guidelines for physicians. Ed. V.A. Isakov. Second edition. St. Petersburg, SpetsLit, 2013, 670 p. (In Russ.) ISBN 978-5-299-00454-0
  2. Malashenkova I.K. et al. Clinical forms of chronic EpsteinBarr virus infection: diagnosis and treatment. Lechashchy vrach, 2003, no. 9, pp. 8–10. (In Russ.)
  3. The modern aspects of herpesvirus infection. Epidemiology, clinical presentations, diagnosis, treatment and prevention. Moscow Government Health Department. Compiled by Karazhas N.V. et al. Moscow, Spetskniga, 2012, 128 p. (In Russ.)
  4. Agut H. Acute human herpesvirus 6 (HHV‑6) infections: when and how to treat? Pathol. Biol. (Paris), 2011, vol. 59, no. 2, pp. 108–112.
  5. Boeckh M., Nichols W.G. Immunosuppressive effects of beta-herpesviruses. Herpes, 2003, vol. 10, pp. 12–16.
  6. Fishman J.A., Rubin R.H. Infection in organ-transplant recipients. N. Engl. J. Med., 1998, vol. 338, pp. 1741– 1751.
  7. Ljungman P. β-Herpesvirus challenges in the transplant recipient. J. Infect. Dis., 2002, vol. 186, Suppl. 1, pp. 99–109.
  8. Maciejewski J.P., Luppi M., Torelli G. Human cytomegalovirus, human herpesvirus 8, and other herpesviruses. Clinical hematology, St. Louis, Mosby, 2006, pp. 967–980.
  9. Miller R. HIV-associated respiratory diseases. Lancet, 1996, vol. 3, no. 348 (9023), pp. 307–312.
  10. Patience T. et al. Mycobacterium tuberculosis subverts negative regulatory pathways in human macrophages to drive immunopathology. PLOS, June 1, 2017, vol. 13, no. 6. https://doi.org/10.1371/journal.ppat.1006367
  11. Pebody R.G. et al. The seroepidemiology of herpes simplex virus type 1 and 2 in Europe. Sex Transm. Infect. 2004, vol. 80, pp.185–191.
  12. Rea T.D. et al. Prospective study of the natural history of infectious mononucleosis caused by EpsteinBarr virus. J. Am. Board Fam. Pract., 2001, vol. 14, pp. 234–242.
  13. Salgame P. Host innate and Th1 responses and the bacterial factors that control Mycobacterium tuberculosis infection. Curr. Opin. Immunol., 2005, vol. 17, pp. 374–380.
  14. Zerr D.M., Meier A.S., Selke S.S. et al. A populationbased study of primary human herpesvirus 6 infection. N. Engl. J. Med., 2005, vol. 352, pp. 768–776.

TB, HIV-infection, herpesvirus infection, Epstein-Barr virus, cytomegalovirus, simple herpes virus, human herpes virus 6, drug resistance of M. tuberculosis.


TB Clinical Hospital No. 3 named after Prof. G.A. Zakharyin

29, Kurkinskoye shosse, 125466, Moscow, Russia

Aleksey M. Shibanov, Phthisiatrician, Division for Phtisiology, Head

Tel.: +7 (495) 571-24-30

E-mail: shiblo@mail.ru

Alexander L. Sobkin, Candidate of Medical Sciences, Chief Physician

Tel.: +7 (495) 572-71-45

E-mail: Tkb_3@mail.ru

Russian National Research Medical University named after N.I. Pirogov

1, Ostravityanov St., 117997, Moscow, Russia

Vladimir A. Stakhanov, Doctor of Medical Sciences, Head of Phthisiology Department

Tel.: +7 (499) 120-82-95

E-mail: stakhanov03@rambler.ru

N.F. Gamaleya Research Institute of Epidemiology and Microbiology

18, Gamaleya St., 123098, Moscow, Russia

Natalia V. Karazhas, Doctor of Biological Sciences, Head of Laboratory of Opportunistic Infections Epidemiology

Tel.: +7 (499) 193-43-89

E-mail: karazhas@inbox.ru

First Moscow State Medical University named after I.M. Sechenov

8, Build. 2, Trubetskaya St., 119991, Moscow, Russia

Roman E. Boshyan, Candidate of Medical Sciences, Associate Professor, Department of Microbiology, Virology and Immunology

Tel.: +7 (903) 160-29-85

E-mail: rbrm@mail.ru


Article 4.Page 38.


DOI: 10.7868/S2587667820010045


Zakharov A.V.

Yaroslavl Oblast Clinical TB Hospital, Yaroslavl, Russia


Submitted as of 16.12.2019

In the WHO consolidated guidelines on drug-resistant tuberculosis (TB) treatment [5] the study of optimization of treatment for isoniazid-resistant TB with confirmed sensitivity to rifampicin and additional resistance to other drugs is considered as one of the priority areas of research. To investigate the clinical course and the treatment efficacy in isoniazid-resistant TB patients we carried out a retrospective analysis of 650 case histories of HIV-negative patients with different spectra of drug

resistance. We established that in 58.9% of patients isoniazid-resistant TB was diagnosed during retreatment, and in 48.6% of patients this disease had infiltrative form. Different extent lung lesions were equally frequent in isoniazid-resistant patients, with some tendency to segmental or lobar localizations. We observed multiple cavities in 58.8% of patients; in 49.5% cavity size reached 2–4 cm. There were 15 variants of the isoniazid-resistance spectrum; HSE and HSEKm dominated. The case histories of 53.9% of MDR TB patients showed isoniazid-resistant spectra of M. tuberculosis. Sputum conversion by the end of the 8th month of treatment was observed in 49.7% of patients with resistance to isoniazid, cavity closure – in 38.3% of such patients. We established that M. tuberculosis resistance to isoniazid was associated with severe clinical and radiological presentations; treatment efficacy in such patients was lower than that in drug-susceptible patients by 20–25%.

  1. Burmistrova I.A., Samoilova A.G., Glebov K.A. et al. The drug resistance spectrum of M. tuberculosis with sensitivity to rifampicin and resistance to isoniazid in pulmonary TB patients. Tuberculosis and Lung Diseases, 2018, vol. 96, no. 12, pp. 63–64. (In Russ.) DOI: 10.21292/2075-1230-2018-96-12-63-64.
  2. Vasilyeva I.A., Samoilova A.G., Ergeshov A.E. TB chemotherapy: problems and prospects. Annals of the Russian academy of medical sciences, 2012, no. 11, pp. 9–14. (In Russ.)
  3. Nechaeva O.B., Gordina A.V., Sterlikov S.A., Kucheryavaya D.A., Son I.M., Zaichenko N.M., Ponomarev S.B. The resources and the activities of TB organizations in the Russian Federation in 2016–2017 (statistical data). Moscow, RIO CNIIOIZ, 2018, 95 p. (In Russ.)
  4. Salina T.Yu., Morozova T.I. The prevalence of mutations in M. tuberculosis genes encoding resistance to isoniazid and rifampicin in TB patients of different age groups. Tuberculosis and Lung Diseases, 2019, vol. 97, no. 4, pp. 12–18. (In Russ.) DOI: 10.21292/2075-1230-2019-97-4-12-18.
  5. The WHO consolidated guidelines on drug-resistant tuberculosis treatment. Geneva, WHO, 2019, 99 p.
  6. Federal clinical recommendations on diagnosis and treatment of pulmonary TB with multi- and extensive drug resistance. The third edition. Moscow–Tver, Triada, 2015, 68 p. (In Russ.)
  7. Federal clinical recommendations on diagnosis and treatment of pulmonary TB. Moscow, New Terra, 2016, 52 p. (In Russ.)
  8. Zhang Y., Yew W.W. Mechanisms of drug resistance in Mycobacterium tuberculosis. The International Journal of Tuberculosis and Lung Disease, 2009, vol. 13, no. 1, pp. 1320–1330.

TB, drug resistance, treatment, isoniazid, M. tuberculosis.


Yaroslavl Oblast Clinical TB Hospital

43, Sobinov St., 150000, Yaroslavl, Russia

Andrey V. Zakharov, Doctor of Medical Sciences, Head of Pulmonary TB Department

Tel.: +7 (4852) 43-91-03

E-mail: Yrzahan@mail.ru


Article 5.Page 46.


DOI: 10.7868/S2587667820010057


Gordeeva O.M., Karpina N.L., Amansakhedov R.B., Mikhailov S.G.

Central TB Research Institute, Moscow, Russia


Submitted as of 10.12.2019

The TB incidence rate in patients with end-stage chronic kidney disease (ESKD) exceeds the similar rate in the general population ten times. The absence of typical radiological semiotics hinders TB diagnostics in such patients. We analyzed the radiological data from 80 ESKD patients with newly detected changes in the lungs and/or the intoxication syndrome of unclear genesis. The investigation revealed TB in 61.25% of the patients: 40% had active TB, and 21.25% had residual post-TB changes in the lungs. Chronic non-tuberculous pulmonary diseases were diagnosed in 38.75% of the patients. We established low informativity of plain chest radiography compared to computed tomography (CT) scanning of the chest in ESKD patients. These methods allowed diagnosing infiltrative (23.75% vs. 48.75%) and focal (71.25% vs. 17.5%) changes in the lungs, which indicated the necessity to perform CT scanning for all ESKD patients with presumed TB. The detection of infiltrative and focal changes in the lungs or their combination witnessed a pulmonary disease, which required immediate diagnostics, but such changes were not pathognomonic for TB. The analysis of CT data allowed determining a number of radiological signs typical for active pulmonary TB in ESKD patients. It was essential for TB diagnostics in this category of immunocompromised individuals.

  1. Banaga Amin S.I., Siddiq Nihad K., Alsayed Randa T., Babiker R., Elmusharaf K. Prevalence and presentation of tuberculosis among hemodialysis patients in Khartoum, Sudan. Saudi J. Kidney Dis. Transpl., 2016, vol. 27, no. 5, pp. 992–996.
  2. Kane Y., Faye M., Lemrabott A.T., Keita A.I., Seck S.M., Cisse M.M., Diallo K., Ka E.F., Niang A., Diouf B. Relevance of the GeneXpert test for the diagnosis of TB in chronic hemodialysis patients in Casamance, South of Senegal. J. Kidney, 2016, vol. 2, p. 133. DOI: 10.4172/2472-1220.1000133
  3. Kayabasi H. The prevalence and the characteristics of tuberculosis patients undergoing chronic dialysis treatment: experience of a dialysis center in southeast Turkey. Renal failure, 2008, vol. 30, no. 5, pp. 513–519.
  4. National Tuberculosis Advisory Committee: Position statement on interferon-gamma release immunoassays in the detection of latent tuberculosis infection [Electronic resource]. Australian Government, Department of Health and Ageing. Mode of access: Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/cdna-ntac-interferon.htm
  5. Rao T.M. Tuberculosis in haemodialysis patients: A single centre experience. Indian Journal of Nephrology, 2013, vol. 23, no. 5, pp. 340–345.
  6. Reis-Santos B., Gomes T., Lessa H.B., Leonor N.M.E. Tuberculosis prevalence in renal transplant recipients: systematic review and meta-analysis. J. Bras. Nefrol., 2013, vol. 35, no. 3, pp. 206–213. DOI: 10.5935/0101-2800.20130033
  7. Unsal A., Ahbap E., Basturk T., Koc Y., Sakaci T., Arar A.S., Kayabasi H., Sevinc M. Tuberculosis in dialysis patients: a nine-year retrospective analysis. J. Infect. Dev. Ctries., 2013, vol. 7, no. 3, pp. 208–213.
  8. Vartian C.V. Tuberculosis in dialysis patients: An old association revisited. Infectious Diseases in Clinical Practice, 1997, vol. 6, no. 4, pp. 247–249.

TB diagnostics, end-stage kidney disease, computed tomography of the chest, radiological semiotics of TB.


Central TB Research Institute

2, Yauzskaya alley, 107564, Moscow

Olga M. Gordeeva, Junior Researcher, Phthisiatrician

Tel.: +7 (499) 785-90-26

E-mail: hobbetxe@mail.ru

Natalia L. Karpina, Doctor of Medical Sciences, Phthisiatrician, Head of Centre for Diagnosis and Rehabilitation of Pulmonary Diseases, Deputy Director

Tel.: +7 (499) 785-90-26

E-mail: natalya-karpina@rambler.ru

Resulguly B. Amansakhedov, Senior Researcher, Candidate of Medical Sciences, Radiologist

Tel.: +7 (499) 780-49-56

E-mail: rasul.amansahedov@mail.ru

Stanislav G. Mikhailov, Radiologist

Tel.: +7 (916) 234-66-04

E-mail: docses@mail.ru


Article 6.Page 57.


DOI: 10.7868/S2587667820010069


Makarov P.V.

Tver State Medical University, Tver, Russia


Submitted as of 10.12.2019

TB is one of the most common secondary diseases during late stage HIV infection; TB causes severe damages in different anatomical sites and is responsible for many lethal outcomes. According to the accepted standards, administration of antiretroviral therapy (ART) is indicated for all patients with HIV/TB co-infection. However, different obstacles may affect this option. For example, the intoxication syndrome development after ART commencement at the 4th stage of HIV is a frequent indication for ART discontinuation. It is necessary to develop simple criteria for predicting ART effectiveness in HIV/TB co-infected patients.

Aim: To improve treatment effectiveness in HIV/TB co-infected patients based on lipid exchange rates.

Materials and methods. We studied the lipid spectrum of the blood serum from patients with HIV/TB coinfection. Patients were divided in three groups. We studied cholesterol levels, some phospholipid fractions in the blood serum from 50 healthy individuals (control group), 50 HIV/TB patients on TB treatment without ART (group 1), 50 HIV/TB patients with preserved drug sensitivity on TB treatment with ART (group 2), 50 HIV/TB patients with multidrug resistance (MDR) on TB treatment with ART (group 3).

Results. ART decreased the level of cholesterol, which was a nutrient for M. tuberculosis. The lowest level of cholesterol was reached in MDR TB patients. Based on the study outcomes, we have developed a method for predicting ART effectiveness in HIV/TB patients: the numeric value of cholesterol-to-triglyceride ratio less than 5.0 is a marker of ART effectiveness (Patent no. 2 666 233 of 06.09.2018).

  1. Dolgova E.A., Alvarez Figueroa M.V., Lobasheva G.P. et al. Determination of resistance to rifampicin in HIV-infected TB patients with secondary diseases. Tuberculosis and Lung Diseases, 2014, no. 4, pp. 129–130. (In Russ.)
  2. Kaminskaya G.O., Abdullaev R.Yu. Tuberculosis and lipid exchange. Tuberculosis and Lung Diseases, 2016, no. 6, pp. 53–63. (In Russ.)
  3. Makarov V.K. Phospholipid spectrum of blood serum in diagnostic of different stages of combined hepatic viral-alcoholic damage. Biomed. Khim., 2004, vol. 50, no. 5, pp. 498–501. (In Russ.)
  4. Nechaeva O.B. The situation of TB and HIV-infection in Russia. Tuberculosis and Lung Diseases, 2014, no. 6, pp. 9–15. (In Russ.)
  5. Panteleev A.M. Drug-resistant TB in HIV-infected patients. In: Relevant problems and prospects of TB service in the Russian Federation. Proceeding of the 1st Congress of the National Association of Phthisiatricians. St. Petersburg, 2012, pp. 281–283. (In Russ.)
  6. Frolova O.P., Shchukina I.V., Frolov E.G. The analysis of mortality due to TB associated with HIV infection. Tuberculosis and Lung Diseases, 2014, no. 7, pp. 32–36. (In Russ.)
  7. Crain R.C. Phospholipid transfer proteins as probes of membrane structure and function. Subcell. Biochem.,1990, no. 16, pp. 4567.
  8. Folch J., Lees M., Stanley G.H.G. A simple method for the isolation and purification of total lipids from animal tissues. J. Biol. Chem., 1957, no. 226, pp. 497–509.
  9. Marsh J.B., Weinstein P.B. Simple charring methods for determination of Lipids. J. Lip., 1966, no. 7, pp. 574–576.
  10. Martens G.W., Arikan M.C., Lee J. et al. Hypercholesterolemia impairs immunity to tuberculosis. Infection and Immunity, 2008, vol. 76, no. 8, pp. 3464–3472. 11. Tarchovskaya T.I. et al. Cholesterol extracted from skin surface as a discriminant of atherosclerosis. Bull. Exp. Med. Biol., 1992, no. 5, pp. 481–483.

TB, HIV infection, antiretroviral therapy, triglycerides, cholesterol, lipids.


Tver State Medical University

4, Sovetskaya St., 170100, Tver, Russia

Pavel V. Makarov, Assistant, Department of Infectious Diseases and Epidemiology

Tel.: +7 (904) 023-13-25

Е-mail: global-create@yandex.ru


Article 7.Page 63.


 DOI: 10.7868/S2587667820010070


Serebryanaya B.A., Lepekha L.N., Abdullaev R.Yu., Chitorelidze G.V., Berezovsky Yu.S., Nikitin S.S., Bagirov M.A.

Central TB Research Institute, Moscow, Russia


Submitted as of 12.12.2019

The research is relevant due to the necessity to characterize the hypercoagulation syndrome with intravascular coagulation and assess morphological changes in the microcircular bed in the lungs of TB patients with concomitant diabetes mellitus (DM) after surgical intervention. Aim: To determine the variability of the hemostasis system indicators, the morphological peculiarities of the pulmonary microcirculation of TB/DM patients depending on the scope of lung surgery. Materials and methods. We analyzed the clinical and laboratory data of 89 TB/DM patients after different scope lung surgery. The patients were divided in 3 groups depending on the scope of lung surgery and compared by intraoperative blood loss. The patients of group 1 underwent lung segmental resection, group 2 – pneumonectomy, group 3 – lobectomy. The hypercoagulation syndrome course was determined by the coagulogram indicators, and the pulmonary microcirculatory bed was studied morphologically. Results. We demonstrated the general tendency in all studied groups – the markers of hypercoagulation started to increase 3–5 days after surgery. By day 20–22, we observed a decrease in the hypercoagulation syndrome markers; however, they still exceeded the baseline values. The most expressive changes in the hemostasis indicators typical for the hypercoagulation syndrome were observed in TB/DM patients after lobectomy. Conclusion. The obtained results can be used to develop anticoagulation therapy regimens.

The article was prepared under scientific research topic no. 0515-2019-0017 “The modern methods of surgical treatment of pulmonary TB with concomitant diabetes mellitus.”

  1. Barkagan Z.S., Momot A.P. The principles of diagnosis of haemostatic disorders. Moscow, 1999. (In Russ.)
  2. Barkagan Z.S., Momot A.P. Diagnosis and directly observed therapy of haemostatic disorders. Moscow, 2001. (In Russ.)
  3. Gilmanov A.Zh., Fazylyev M.M. Disseminated intravascular blood coagulation. Klin. Lab. Diagnostika, 2004, no. 4, pp. 25–32. (In Russ.)
  4. Elipashev A.A., Nikolsky V.O., Shprykov A.S. The predictive value of morphological signs of TB inflammation process in patients with restricted forms of drug resistant pulmonary TB. Arkhiv patologii, 2010, no. 4, pp. 40–43. (In Russ.) DOI:10.17116/patol201779413-17
  5. Erokhin V.V. The morphofunctional state of lung cells in TB inflammation. In: Cell biology of the lungs in health and pathology. Ed. by V.V. Erokhin, L.K. Romanova. Moscow, Medicine, 2000, pp. 422–448. (In Russ.) ISBN 5-225-02675-3
  6. Erokhin V.V., Gedymin L.E., Zemskova Z.S., Lepekha L.N., Parkhomenko Yu.G., Zyuzya Yu.R., Burtseva S.A., Dyukanova M. Ya., Fligil D.M. Pathoanatomical diagnosis of the main forms of TB (according to resection studies). Problems of Tuberculosis and Lung Diseases, 2008, vol. 85, no. 7–8, pp. 45–64. (In Russ.)
  7. Erokhin V.V., Zemskova Z.S. The modern concepts of TB inflammation. Problems of Tuberculosis, 2003, no. 3, pp. 11–21. (In Russ.)
  8. Erokhin V.V. The functional morphology of the lungs. Moscow, Medicine, 1987, 296 p. (In Russ.)
  9. Zhilin Yu.A., Kaminskaya G.O., Serebryanaya B.A., Shipileva N.M., Dmitrenko L.V. The assessment of hemocoagulation disorders in the post-operative period in pulmonary TB patients. The collected works of the Institute, 1997, vol. 21, pp. 110–111. (In Russ.)
  10. Zyuzya Yu.R., Lepekha L.N., Gedymin L.N. et al. Tissue and cell reactions in the lungs in drug resistant TB. Tuberculosis and Lung Diseases, 2004, no. 8, pp. 53–56. (In Russ.)
  11. Zyuzya Yu.R., Lepekha L.N., Gedymin L.N., Burtseva S.A., Erokhin V.V. On the question of morphological diagnosis of drug resistant pulmonary TB. Tuberculosis and Lung Diseases, 2006, no. 10, pp. 56–60. (In Russ.)
  12. Kaminskaya G.O., Serebryanaya B.A., Dmitrenko L.V., Zhilin Yu.N., Shipileva N.M. On pathogenesis of hemocoagulation complications in thoracic surgery. Problems of Tuberculosis, 1976, no. 6, pp. 48–53. (In Russ.)
  13. Kaminskaya G.O., Serebryanaya B.A., Komissarova O.G., Martynova E.V., Mishin V.Yu. Intravascular coagulation as a typical concomitant of acute pulmonary tuberculosis. Problems of Tuberculosis, 1997, no. 3, pp. 42–46. (In Russ.)
  14. Kaminskaya G.O., Martynova E.V., Serebryanaya B.A., Komissarova O.G. The fibrinolytic system in the hypercoagulation syndrome in patients with pulmonary tuberculosis. Problems of Tuberculosis and Lung Diseases, 2004, no. 3, pp. 51–54. (In Russ.)
  15. The clinical laboratory analytics. Ed. by V.V. Menshikov, vol. 3. Moscow, 2000. (In Russ.)
  16. Loshchilov V.G., Serebryanaya B.A., Kazakova L.V. Evaluation of the hemostasis system and detection of intravascular coagulation in phthisiosurgery patients in the modern conditions. Abstracts of the 11th Congress of phthisiatricians, 1992, p. 267. (In Russ.)
  17. Momot A.P., Sidor N.V. Possible involvement of factor XIII in forming a trend towards thrombosis in patients with various types of thrombophilia. Klin. Lab. Diagnostika, 2007, no. 2, pp. 45–47. (In Russ.)
  18. Kokturk N., Varol A., Kilic H., Ekim N. Quantitative D-Dimer levels in pulmonary thromboembolism and community acquired pneumonia. Eur. Respir. J., 2007, no. 30.
  19. Seyhan T.C., Cetinkaya E., Altin S. et al. Evaluation of d-dimer levels in in patients with active pulmonary tuberculosis and latent tuberculosis infection. Eur. Respir. J. 2006, no. 28, suppl. 50, p. 164s.

pulmonary TB, diabetes mellitus, surgical intervention, hypercoagulation syndrome, microcircular bed.


Central ТВ Research Institute

2, Yauzskaya alley, 107564, Moscow, Russia

Bella A. Serebryanaya, Candidate of Biological Sciences, Leading Researcher, Department of Pathomorphology, Cell Biology and Biochemistry

Tel.: +7 (917) 582-72-66

E-mail: bellaabramovna@yandex.ru

Larisa N. Lepekha, Doctor of Biological Sciences, Professor, Acting Principal Researcher, Head of Department of Pathomorphology, Cell Biology and Biochemistry

Tel.: +7 (495) 785-91-79

E-mail: lep3@yandex.ru

Rizvan Yu. Abdullaev, Doctor of Medical Sciences, Professor, Head of Biochemistry Laboratory, Department of Pathomorphology, Cell Biology and Biochemistry

Tel.: +7 (495) 748-30-23

E-mail: rizvan0403@yandex.ru

Georgy V. Chitorelidze, Postgraduate, Surgery Department

Tel.: +7 (964) 622-84-44


Article 8.Page 74.


DOI: 10.7868/S2587667820010082


Bayke E.E., Rogova O.O., Arkhipova M.V.

Chita State Medical Academy, Chita, Russia


Submitted as of 06.12.2019

Clinical observation of a HIV-positive patient with developing generalized TB is represented. The patient did not receive antiretroviral therapy (ART). Despite advanced injury of the organs and the systems, adequate treatment resulted in a favourable outcome.

  1. Vasilyeva I.A., Belilovsky E.M., Borisov S.E., Sterlikov S.A., Sinitsyn M.V. Tuberculosis with concurrent HIV infection in the Russian Federation and the world. Tuberculosis and Lung Diseases, 2017, vol. 95, no. 9, pp. 8–18. (In Russ.)
  2. Nechaeva O.B. The epidemic situation of TB among people living with HIV in the Russian Federation. Tuberculosis and Lung Diseases, 2017, vol. 95, no. 3, pp. 13–19. (In Russ.)
  3. Panteleev A.M. Clinical understanding of the pathogenesis of TB generalization in HIV-infected patients. Tuberculosis and Lung Diseases, 2015, no. 2, pp. 26–31. (In Russ.)
  4. Shimao T. Speculation on reasons why co-infection of tuberculosis and HIV is rather rare in Japan. Kekkaku, 2014, vol. 89, nо. 2, pp. 57–60.

tuberculosis, Mycobacterium tuberculosis, HIV infection, antiretroviral therapy.


Chita State Medical Academy

39A, Gorky St., 672000, Chita, Russia

Evgeny E. Bayke, Candidate of Medical Sciences, Associate Professor, Head of Tuberculosis Department

Tel.: +7 (914) 485-11-71

E-mail: eugenij.bee@yandex.ru

Olga O. Rogova, a sixth-year student, Medical Faculty

Tel: +7 (914) 139-90-82

E-mail: rogova.olga.97@mail.ru

Maria V. Arkhipova, a sixth-year student, Medical Faculty

Tel: +7 (914) 495-50-62


Article 9.Page 79.


DOI: 10.7868/S2587667820010094


Sevastyanova E.V., Larionova E.E., Andrievskaya I.Yu., Smirnova T.G.

Central TB Research Institute, Moscow, Russia


Submitted as of 18.12.2019

We have outlined the guiding principles, which underpin the preparation of diagnostic samples for microbiological detection of mycobacteria. We presented the basic provisions related to quality  ontrol during collection, storage or transportation of diagnostic samples, reception and registration by a laboratory.

  1. Golyshevskaya V.I., Shulgina M.B., Sevastyanova E.V., Akimkin B.G., Vanina G.M., Vakhrusheva D.V., Vishnevsky B.I., Vladimirsky M.A., Irtuganova O.A., Kravchenko M.A., Otten T.F., Popov S.A., Safonova S.G., Fedorova L.S. Cultural methods of TB diagnosis: an educational manual for the basic training course for bacteriologists of TB institutions. Ed. by V.V. Erokhin, Moscow-Tver, Triada, 2008, 208 p. (In Russ.)
  2. GOST R ISO 15189-2015 Medical laboratories. The detailed requirements for quality and competence. The national standard of the Russian Federation. (In Russ.)
  3. On improvement of TB control measures in the Russian Federation. Edict no. 109 by RF MoH as of 21.03.2003. Annex no. 11. The instruction for the unified methods of microbiological studies for detection, diagnosis and treatment of TB. (In Russ.)
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mycobacteria, diagnostic samples.


Central TB Research Institute

2, Yauzskaya alley, 107564, Moscow, Russia

Elina V. Sevastyanova, Doctor of Biological Sciences, Leading Researcher, Microbiology Department

Tel.: +7 (499) 785-90-91

Е-mail: elinasev@yandex.ru

Elena E. Larionova, Candidate of Biological Sciences, Senior Researcher, Microbiology Department

Tel.: +7 (499) 785-90-91

E-mail: larionova_lena@mail.ru

Irina Yu. Andrievskaya, Researcher, Microbiology Department

Tel.: +7 (499) 785-90-91

Е-mail: andrievskaya.iri@mail.ru

Tatiana G. Smirnova, Candidate of Medical Sciences, Senior Researcher, Microbiology Department

Tel.: +7 (499) 785-90-91

Е-mail: s_tatka@mail.ru