Поступила в редакцию 27.01.2026
Принята к публикации 10.03.2026
Опубликована 20.03.2026
УДК: 616.24-002.5-079.6
DOI: 10.26212/2227-1937.2026.26.21.010
FEATURES OF THE COURSE OF TUBERCULOSIS SEPSIS DURING HIV INFECTION
Muzdubayeva B.T.
National Scientific Center of Phthisiopulmonology of the Republic of Kazakhstan, Almaty, Kazakhstan
Abstract .Tuberculosis remains one of the main causes of death in HIV-infected people, complicating the course of HIV infection, which is still difficult to diagnose with this combination. HIV infection at the stage of secondary diseases dramatically increases the risk of developing tuberculosis. Active tuberculosis can develop at any stage of HIV infection and has many clinical, radiological, and morphological features that depend on the severity of the immunodeficiency. The
growing number of HIV-infected patients with clinical manifestations of sepsis requires modern, fast and reliable methods of etiological diagnosis. HIV infection at the stage of secondary diseases in stage IV significantly increases the number of forms of active tuberculosis in such patients. According to Russian and foreign authors, the proportion of tuberculosis patients among HIV-infected people reaches 75%. Tuberculosis associated with HIV often takes a generalized form,
including tuberculosis sepsis, and requires the immediate initiation of combination therapy.
Objective. To give a clinical description of tuberculosis sepsis in HIV infection.
Materials and Methods. The article is written taking into account the results of the review of scientific literature. The article uses scientific approaches and a set of methods, including clinical and epidemiological analyses.
Results. Mortality among patients with various forms of bacterial sepsis admitted to intensive care units worldwide is 36.2–47.7%, and in 64% of cases the source of infection is the lungs. Tuberculous sepsis is characterized by the presence of many submiliary foci of dissemination in organs and tissues, often with minor radiological changes in the lungs. In tuberculosis sepsis, even a thorough diagnostic search may not reveal the primary source of infection.
Discussion. Tuberculous sepsis is often a generalized form of tuberculosis, the clinical manifestations are nonspecific, diverse, with undetected laboratory changes. The manifestation of the disease occurs violently within 10-30 days, often with a fatal outcome in 30-40% of cases, even with parenteral administration of antimicrobial therapy.
Conclusions. Timely detection of tuberculosis in HIV infection will make it possible to promptly intensify therapy, including not only specific antimicrobial therapy, but also early targeted hemodynamic support, and correction of antibacterial therapy taking into account microbiological crops. This will improve treatment outcomes and reduce mortality from sepsis in tuberculosis patients.
Keywords: HIV infection, generalized tuberculosis, sepsis.
