DETECTION OF TUBERCULOSIS COMBINED WITH HIV INFECTION USING THE IGRA LABORATORY TEST IN PEDIATRIC PRACTICE: A CASE REPORT

<jats:p>The search for new opportunities for early detection of tuberculosis infection (TI) and prevention of tuberculosis (TB) in children from risk groups remains relevant. HIV infection is one of the highest risk factors for TB disease. According to the literature, the ELISPOT method is effective for detecting TI regardless of the presence of immunosuppression. In 2025, in vitro laboratory tests based on the assessment of T-lymphocyte interferon-gamma release (IGRA tests) were introduced into clinical practice in the Russian Federation. This case report demonstrates a case of generalized TB in a school-age child with HIV infection, which was first diagnosed at the age of 13 years when seeking medical attention with complaints. The child was hospitalized with a preliminary diagnosis: Crohn's disease, terminal ileitis, stenosing form, moderate severity, stenosis of the terminal ileum. HIV infection? Anamnestic, general clinical data, and results of additional examination methods (radiological, immunological, microbiological) did not allow confirmation of the etiological nature of TB; obtaining morphological data required an aggressive diagnostic approach. A positive IGRA test (blood test using the ELISPOT method) allowed confirmation of the presence of TI in the child and, in conjunction with clinical and radiological data, established the diagnosis of TB, followed by an effective course of anti-tuberculosis chemotherapy against the background of antiretroviral therapy (ART) and achievement of clinical cure. The positive dynamics of the immune status in the child led to the conversion of negative skin immunological tests for TI to positive, which clearly demonstrates the pathogenetic mechanism of various methods of immunodiagnosis of TI. Changes in approaches to TB screening of the pediatric population involve the use of in vitro tests based on the assessment of T-lymphocyte interferon-gamma release (IGRA tests). Immunodeficiency states of various origins are medical indications for laboratory tests using the ELISPOT method.</jats:p>