Features of diagnostics of the peripheral lymph nodes tuberculosis

The analysis of the features of diagnostics of peripheral lymph nodes tuberculosis in modern conditions is carried out. For this 28 case histories of patients suffering from tuberculosis of peripheral lymph nodes were studied and 85,7% of them had a combination of tuberculosis and infection caused by the human immunodeficiency virus. All patients were undergoing biopsies or surgery of lymph nodes, and the material was examined using microbiological molecular, genetic and histological methods. 85,7% of patients had relapses with different periods of time, on average, 34 years, and repeated periods of tuberculosis activation. At all patients the lymph nodes were enlarged, mainly cervical (71,4%) and axillary (67,9%), the sizes of nodes varied from 1 to 5 cm, on average, 2,21,6 cm. In 78,6% cases tuberculosis of peripheral lymph nodes was characterized by fluctuation of nodes and the discharge of 30 to 80 ml of odorless creamy pus. It was found that tuberculosis of peripheral lymph nodes is part of a widespread tuberculous lesions especially at patients with tuberculosis associated with an infection caused by the human immunodeficiency virus. Tuberculosis of peripheral lymph nodes develops simultaneously with a specific lesion of other groups of lymph nodes intrathoracic (75%), intra-abdominal (57,1%), which allows to generalized tuberculosis of the lymphatic system. Fibrobronchoscopy showed in 35,7% patients residual bronchial tuberculosis changes, at 14,3% an active fistulous form of bronchial tuberculosis. Microscopy of biopsy material was negative at 78,6% of cases, while cultural examination revealed Mycobacterium tuberculosis in 100% and molecular genetic studies deoxyribonucleic acid of Mycobacterium tuberculosis in 64,3% patients.

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Lymphatic Targeting of Anti-Human Immunodeficiency Virus Nucleosides: Pharmacokinetics of G′-Deoxy-2′,3′-Didehydrothymidine after Intravenous and Oral Administration of Dipalmitoylphosphatidyl Prodrug to Mice

Antiviral Chemistry and Chemotherapy ◽

10.1177/095632029700800503 ◽

1997 ◽

Vol 8 (5) ◽

pp. 409-415 ◽

Cited By ~ 2

Author(s):

KK Manouilov ◽

Z-S Xu ◽

LS Manouilova ◽

FD Boudinot ◽

RF Schinazi ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Lymph Nodes ◽

Extended Release ◽

Lymphatic System ◽

Parent Compound ◽

Equimolar Dose ◽

Lipophilic Prodrug ◽

Immunodeficiency Virus ◽

Intravenous And Oral Administration ◽

Therapy Strategies

The lymphatic system is a primary target for early anti-human immunodeficiency virus drug therapy. Strategies are currently being sought to enhance the delivery of nucleoside analogues such as 3′-deoxy-2′,3′-didehydrothymidine (stavudine; d4T) toward the lymph and lymph nodes. The purpose of this study was to synthesize dipalmitoylphosphatidyl-d4T (DPP-d4T) as a lipophilic prodrug of d4T and to evaluate the lymphatic distribution of d4T following administration of d4T and DPP-d4T to mice. The pharmacokinetics of d4T were characterized following administration of a single intravenous or oral dose of 50 mg kg−1 d4T and an equimolar dose (214 mg kg−1) of DPP-d4T. Concentrations of d4T in serum and lymph nodes were determined by HPLC. Following administration of d4T, the distribution of d4T into lymph nodes was rapid with maximum concentrations observed within 5 min after dosing. The AUC and half-life values of d4T in three groups of lymph nodes were similar to those in serum. Administration of DPP-d4T resulted in significantly lower concentrations of d4T in serum and lymph nodes. Approximately 67% of the intravenously administered DPP-d4T was biotransformed to parent compound. The apparent oral bioavailability of DPP-d4T was low. While the phospholipid prodrug did not increase d4T concentrations in the lymph nodes, it did provide an extended release of the parent nucleoside, resulting in sustained concentrations of d4T.

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The spectrum of primary drug resistance of Mycobacterium tuberculosis in patients with tuberculosis in relation to human immunodeficiency virus status

Terapevticheskii arkhiv ◽

10.17116/terarkh2017891150-54 ◽

2017 ◽

Vol 89 (11) ◽

pp. 50-54 ◽

Cited By ~ 1

Author(s):

V N Zimina ◽

O E Mikova ◽

T A Varetskaya ◽

D A Oborin ◽

S Yu Degtyareva ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Drug Resistance ◽

Mycobacterium Tuberculosis ◽

Molecular Genetic ◽

Diagnostic Algorithm ◽

Human Immunodeficiency Virus Status ◽

Bacteriological Examination ◽

Primary Drug Resistance ◽

Immunodeficiency Virus ◽

Primary Drug

Aim. To estimate the detection rate and spectrum of primary drug resistance of Mycobacterium tuberculosis (MBT) in patients with tuberculosis (TB) in relation to their human immunodeficiency virus (HIV) status in a region with high HIV infection rates (the Perm Territory) and to compare of drug-resistant MBT (DR-MBT) in patients with HIV/TB co-infection, by using phenotypic and molecular genetic testing (MGT) methods. Subjects and methods. The results of sputum bacteriological examination were analyzed in 178 HIV-infected patients and 354 non-HIV-infected individuals with a TB diagnosis made in the period July 1, 2014 to August 1, 2015. The diagnostic algorithm for all patients involved a duplicate sputum test for MBT by two techniques: fluorescence microscopy (FM) and inoculation into the Levenstein-Jensen dense culture medium. In patients with HIV/TB, the bacteriological examination was complemented with two more methods: detection of MBT DNA by a real-time polymerase chain reaction assay using the AmpliTube-RV system (Synthol, Russia); and inoculation into the Middlebrook liquid nutrient medium, by applying the automated BACTEC MGIT 960 system. Results. In patients with HIV/TB, the sensitivity of FM proved to be lower than in those with TB (24.2 and 32.8%, respectively; p0.05). The primary drug resistance of MBT in patients with HIV-TB was higher than that in HIV-negative individuals (60.2 and 41.6%, respectively; p

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A Randomized Controlled Trial of Isoniazid to Prevent Mycobacterium tuberculosis Infection in Kenyan Human Immunodeficiency Virus–Exposed Uninfected Infants

Clinical Infectious Diseases ◽

10.1093/cid/ciaa827 ◽

2020 ◽

Cited By ~ 1

Author(s):

Sylvia M LaCourse ◽

Barbra A Richardson ◽

John Kinuthia ◽

A J Warr ◽

Elizabeth Maleche-Obimbo ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Mycobacterium Tuberculosis ◽

High Risk ◽

Adverse Events ◽

Controlled Trial ◽

Preventive Therapy ◽

Infection Prevalence ◽

Mycobacterium Tuberculosis Infection ◽

Immunodeficiency Virus ◽

Exposed Uninfected

Abstract Background Human immunodeficiency virus (HIV)–exposed uninfected (HEU) infants in endemic settings are at high risk of tuberculosis (TB). For infants, progression from primary Mycobacterium tuberculosis (Mtb) infection to TB disease can be rapid. We assessed whether isoniazid (INH) prevents primary Mtb infection. Methods We conducted a randomized nonblinded controlled trial enrolling HEU infants 6 weeks of age without known TB exposure in Kenya. Participants were randomized (1:1) to 12 months of daily INH (10 mg/kg) vs no INH. Primary endpoint was Mtb infection at end of 12 months, assessed by interferon-γ release assay (QuantiFERON-TB Gold Plus) and/or tuberculin skin test (TST, added 6 months after first participant exit). Results Between 15 August 2016 and 6 June 2018, 416 infants were screened, with 300 (72%) randomized to INH or no INH (150 per arm); 2 were excluded due to HIV infection. Among 298 randomized HEU infants, 12-month retention was 96.3% (287/298), and 88.9% (265/298) had primary outcome data. Mtb infection prevalence at 12-month follow-up was 10.6% (28/265); 7.6% (10/132) in the INH arm and 13.5% (18/133) in the no INH arm (7.0 vs 13.4 per 100 person-years; hazard ratio, 0.53 [95% confidence interval {CI}, .24–1.14]; P = .11]), and driven primarily by TST positivity (8.6% [8/93] in INH and 18.1% [17/94] in no INH; relative risk, 0.48 [95% CI, .22–1.05]; P = .07). Frequency of severe adverse events was similar between arms (INH, 14.0% [21/150] vs no INH, 10.7% [16/150]; P = .38), with no INH-related adverse events. Conclusions Further studies evaluating TB preventive therapy to prevent or delay primary Mtb infection in HEU and other high-risk infants are warranted. Clinical Trials Registration NCT02613169.

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