Maniv L. Efficacy and tolerability of antimycobacterial chemotherapy in patients with new TB/HIV co-infection cases and concomitant hepatitis B and C

Object of study: new TB/HIV co-infection cases and concomitant hepatitis В and С; the aim - improve treatment efficacy among patients with new TB/HIV co-infection cases and concomitant hepatitis В and С through elaboration of antimycobacterial chemotherapy depending on clinical-laboratory results and instrumental examination findings of liver condition, in order to prevent severe hepatotoxic adverse events; methods of investigation: clinical, biochemical, instrumental (liver ultrasound diagnostic), roentgenologic, microbiological, immunological, statistical; the novelty: for the first time was established the adverse events сaused with standard antituberculosis chemotherapy in patients with TB/HIV co-infection develop, both with and without antiretroviral therapy, almost in the same number of patients. Were established extended risk factors for development of hepatotoxic adverse reactions: increase of alanineaminotransferase more than twofold; increase of total bilirubin over 20 µmol/L; simultaneous increase of alanineaminotransferase and total bilirubin irrespective of the rates; decrease of blood albumin below 3.5 g/L; visualization of ultrasound signs of hepatic lesions manifesting as changes in its parenchyma echogenicity. A new treatment method was developed for patients with new TB/HIV co-infection cases and concomitant hepatitis В and С. It was proved that intake of moxifloxacin during the intensive phase of chemotherapy instead of pyrazinamide allows to improve treatment efficacy and its tolerability. Scope - medicine.