Hepatotoxic Reactions During Treatment of Newly Diagnosed Patients With Pulmonary Multiple Drug Resistant Tuberculosis

Абдуллаев, Р. Ю.; Komissarova, Oksana; Chumakova, Elena; Odinets, V.S.; Ergeshov, Atadzhan

doi:10.21292/2075-1230-2019-97-7-21-27

TIBL

2019

DOI: 10.21292/2075-1230-2019-97-7-21-27

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Hepatotoxic Reactions During Treatment of Newly Diagnosed Patients With Pulmonary Multiple Drug Resistant Tuberculosis

Р. Ю. Абдуллаев¹,

Oksana Komissarova²,

Elena Chumakova³

et al.

Abstract: 2 ГУЗ «Краевой клинический противотуберкулезный диспансер», г. Ставрополь, РФ 3 Российский национальный исследовательский медицинский университет (РНИМУ) им. Н. И. Пирогова, Москва, РФ Обследовано 216 впервые выявленных больных туберкулезом легких с множественной лекарственной устойчивостью (МЛУ) возбудителя. Пациенты были разделены на 2 группы. Первую группу составили 164 больных, у которых при поступлении в стационар методом GeneXpert MTB/RIF определялась устойчивость микобактерий туберкулеза (МБТ) к рифампи… Show more

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Cited by 4 publications

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Clinical and Epidemiological Characteristics of COVID-19 in Persons Living with HIV Complicated by Tuberculosis

Lebedeva,

Borodkina,

Bondarenko

et al. 2023

Epidemiology and Vaccinal Prevention

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Relevance. At present, three infections – HIV infection, tuberculosis, and COVID-19 - are spreading simultaneously in the world. Of great practical importance is the assessment of clinical and epidemiological features of COVID-19 in HIV-infected patients with tuberculosis, COVID-19. Aim. To study the risk of COVID-19 disease and identify clinical and epidemiological features in and population of patients with HIV infection complicated by tuberculosis in comparison with patients with HIV infection and the population without these diseases.Materials and methods. Since 13.03.2020 by 31.12.2021 in the Kemerovo Region-Kuzbass, a continuous prospective analytical epidemiological study of the case-control type was performed. Of those with COVID-19, two observation groups were formed: group I (HIV +), group II (HIV/TB) and comparison group III (persons without either HIV or tuberculosis). All patients underwent: determination of SARS-CoV-2 RNA, standard examination methods in accordance with the temporary methodological recommendations «Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)», relevant at the time of treatment.Results. The incidence of COVID-19 among patients with HIV infection complicated by tuberculosis exceeded the incidence of COVID-19 among HIV-infected by 14%. There were no gender differences between patients I (HIV +) and II (HIV/TB) groups. In the comparison group, the incidence of COVID-19 was 1.26 times higher in women compared to men. COVID-19 disease in patients with co-infection (HIV/TB) was predominantly mild. Viral pneumonia developed 1.86 times less often, oxygenotherapy was required only in 18.75% of cases, which is 2.5 times lower than in group I (HIV +) and 2.47 times less than in the comparison group (III). In labeled pairs, clinical symptoms of COVID-19 in all groups occurred with the same frequency. Metabolic disorders were evident in all groups. Co-infected patients (HIV/TB) had higher levels of D-dimer, ESR, total bilirubin.Conclusion. Active tuberculosis in HIV-infected people is a factor that increases the risk of COVID-19 disease without affecting the severity of the infectious process.

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Clinical and Epidemiological Characteristics of COVID-19 in Persons Living with HIV Complicated by Tuberculosis

Lebedeva,

Borodkina,

Bondarenko

et al. 2023

Epidemiology and Vaccinal Prevention

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show abstract

Efficacy of a shorter chemotherapy regimen in a patient with drug-resistant tuberculosis with early surgical intervention

Chumovatov

Komissarova

Chernyh

et al. 2023

jour

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Introduction. Treatment for multidrug-resistant tuberculosis lasts 18 to 24 months, so there is a high rate of therapy interruptions, including patient-initiated interruptions. In recent years, the use of shorter regimens for the treatment of multidrug-resistant tuberculosis has been actively discussed around the world. The first use of shorter chemotherapy regimens was conducted in three regions of the Russian Federation in 2019. However, the prevalence of the use of shorter chemotherapy regimens in our country remains low.The purpose of the study was to demonstrate the high efficacy of a shortened chemotherapy regimen with surgical intervention.Materials and methods. In the conditions of the Central Research Institute of Tuberculosis, the patient underwent a comprehensive examination, including mandatory, additional and optional methods of investigation. Based on the findings of the comprehensive examination and established broad drug resistance of Mycobacterium tuberculosis, a shorter course of chemotherapy was prescribed and surgical treatment was performed after 2 months of therapy.Results and Discussion It was decided to carry out anti-tuberculosis therapy according to a shortened scheme in the amounts: Linezolid, Bedaquiline, Cycloserine, Levofloxacin, Pyrazinamide. Taking into account positive radiological dynamics after two months of treatment and absence of contraindications, early surgery intervention was performed. At the end of a nine-month course of chemotherapy the patient had a stable radiological picture, “fresh” focal and infiltrative changes in the lungs were not detected. Early surgical treatment with a shorter chemotherapy regimen may become a highly effective method in the cure of drug-resistant tuberculosis in the Russian Federation.Conclusion. A shorter chemotherapy regimen with optimal timing of surgical intervention is highly effective and safe to use.

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The Effectiveness of the Use of Collapse Therapy Methods and Bronchoblocation in the Complex Treatment of a Patient with Multidrug Resistance Pathogen: Clinical Observation

Chumovatov,

Komissarova,

Chernyh

et al. 2024

Урал. мед. журнал

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Currently, according to the World Health Organization, the targets for the effectiveness of treatment of patients with pulmonary tuberculosis do not achieve their goals. In this regard, it is urgent to search for optimal integrated approaches in the treatment of patients with pulmonary tuberculosis.The aim of the work is to demonstrate the high effectiveness of the use of methods of collapse therapy and CBB in the complex treatment of a patient with a widespread tuberculosis process.Materials and methods. The analysis of the patient’s medical documentation was carried out, the data of the anamnesis of the disease, the analysis of the X-ray archive, the data of clinical, laboratory and instrumental examinations were studied.Results. Multidrug resistance (MDR) of Mycobacterium tuberculosis (MBT) was established on the 1st day of hospitalization. Comprehensive treatment was carried out in full: chemotherapy according to the MDR-tuberculosis regimen, pneumoperitoneum for 8 months, CBB for 6 months.Discussion. The presented clinical example demonstrates that against the background of a significant decrease in immunity due to the severe course of viral pneumonia, previously undetected pulmonary tuberculosis has taken a progressive course. Due to the use of complex treatment in a patient with a widespread tuberculosis process, clinical improvement was achieved, the closure of massive decay cavities in lung tissue and resorption of focal infiltrative changes was radiologically achieved.Conclusion. A clinical example demonstrates the high effectiveness and safety of the use of collapse therapy methods in the complex treatment.

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Hepatotoxic Reactions During Treatment of Newly Diagnosed Patients With Pulmonary Multiple Drug Resistant Tuberculosis

Cited by 4 publications

References 2 publications

Clinical and Epidemiological Characteristics of COVID-19 in Persons Living with HIV Complicated by Tuberculosis

Clinical and Epidemiological Characteristics of COVID-19 in Persons Living with HIV Complicated by Tuberculosis

Efficacy of a shorter chemotherapy regimen in a patient with drug-resistant tuberculosis with early surgical intervention

The Effectiveness of the Use of Collapse Therapy Methods and Bronchoblocation in the Complex Treatment of a Patient with Multidrug Resistance Pathogen: Clinical Observation

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