Clinical case of immunoglobulin G application with сhemo-­resistant tuberculosis in combination with HIV-infection with severe immunosuppression

2019 ◽  
Vol 0 (1) ◽  
pp. 46-51
Author(s):  
N.А. Matsegora ◽  
A.V. Kaprosh
Keyword(s):  
Hiv Infection ◽  
Immunoglobulin G ◽  
Clinical Case ◽  
Severe Immunosuppression ◽  
Resistant Tuberculosis

scholarly journals Correction to: HIV infection and multidrug resistant tuberculosis: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zeeba Zahra Sultana ◽  
Farhana Ul Hoque ◽  
Joseph Beyene ◽  
Md. Akhlak-Ul-Islam ◽  
Md Hasinur Rahman Khan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Infection ◽  
Meta Analysis ◽  
Multidrug Resistant ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis

An amendment to this paper has been published and can be accessed via the original article.

The effectiveness of immunoglobulin G application in patients with drug­-resistant tuberculosis/HIV with CD4+ lymphocytes from 200 to 50 cells/µl according to biochemical data

2021 ◽  
pp. 43-50
Author(s):  
N.А. Matsegora ◽  
A.V. Kaprosh
Keyword(s):  
Immunoglobulin G ◽  
Biochemical Parameters ◽  
Immunoglobulin Therapy ◽  
Treatment Method ◽  
Control Group ◽  
Second Line ◽  
Resistant Tuberculosis ◽  
Complex Therapy ◽  
Group 2 ◽  
Cd4 Lymphocytes

Objective — to study the effectiveness of immunoglobulin therapy in patients with co-infection of drug-resistant tuberculosis (DR-TB)/HIV at the level of CD4+ lymphocytes from 200 to 50 cells/μl, based on a study of the dynamics of biochemical parameters. Materials and methods. The study involved 52 patients aged 20 to 55 years, with a mean age of (37.2 ± 7.8) years. All patients were HIV-positive with laboratory-confirmed DR-TB with mycobacterial resistance to first- and second-line drugs. Patients with DR-TB/HIV were distributed as follows: 1 group (control) — 26 patients with DR-TB/HIV, receiving standard treatment of second-line AMBP and ARVT; group 2 (main) — 26 patients with DR-TB/HIV, who also received standard treat­ment of second-line AMBP and ARVT, with the addition of complex therapy with intravenous immunoglobulin G (IgG). Results and discussion. Against the background of treatment, the dynamics of changes in biochemical parameters was as follows: patients in the control group, after the first 2 weeks of AMBP, there was an increase in intoxication load on the hepatobiliary and urinary systems, which led, on the one hand, to dysfunction liver with hyperbilirubinemia, increased transaminase activity, thymol turbidity, and on the other — to the development of renal failure with hypercreatininemia, hyperuricemia, azotemia and oliguria. As a result, timely appointment of ARVT (2 weeks after AMBP) in 19 (73.1 %) patients was impossible and was carried out much later than desired (after 2—3 months).Treatment of patients with comorbid pathology of DR-TB/HIV, which included complex intravenous IgG on the background of complex therapy, was accompanied by positive clinical and laboratory dynamics, which created conditions for ARVT involvement after the second week of complex therapy according to the developed treatment method. Conclusions. The use of immunologically targeted treatment with intravenous IgG made it possible to successfully prescribe ARVT to patients of the main group in 2 weeks from the start of AMBT, which is very useful to prevent adverse reactions, increase treatment efficacy and reduce mortality in patients with comorbid DR-TB/HIV in a state of deep immunosuppression.

Multi-drug resistant tuberculosis with simultaneously acquired-drug resistance to bedaquiline and delamanid

2020 ◽  
Author(s):  
Takashi Yoshiyama ◽  
Satoshi Mitarai ◽  
Akiko Takaki ◽  
Akio Aono ◽  
Masao Okumura ◽  
...  
Keyword(s):  
Clinical Case ◽  
Acquired Resistance ◽  
Whole Genome ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Acquired Drug Resistance ◽  
Tuberculosis Isolate ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Nucleotide Insertions

Abstract This study is the first to report a clinical case of simultaneously acquired resistance to bedaquiline (BDQ) and delamanid (DLM). Whole genome sequencing revealed two nucleotide insertions (Rv0678 and fbiC) in the Mycobacterium tuberculosis isolate. The minimum inhibitory concentrations for BDQ and DLM were 0.25 µg/ml and >2.0 µg/ml, respectively.

scholarly journals Increased immunoglobulin G production by short term cultured duodenal biopsy samples from HIV infected patients

Gut ◽  
1998 ◽  
Vol 42 (3) ◽  
pp. 357-361 ◽  
Author(s):  
T Schneider ◽  
T Zippel ◽  
W Schmidt ◽  
G Pauli ◽  
U Wahnschaffe ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Immunoglobulin G ◽  
Duodenal Biopsy ◽  
Mucosal Inflammation ◽  
Short Term ◽  
Immunoglobulin Production ◽  
Secretory Immunity ◽  
Serum Iga ◽  
Intestinal Origin ◽  
Iga Production

Background—Secretory immunity is a major defence mechanism against infections at mucosal surfaces which are common in HIV infected patients.Aims—To analyse intestinal immunoglobulin production in HIV infection in comparison with that in saliva and serum.Patients and methods—Immunoglobulin G (IgG), A (IgA), and M (IgM) concentrations were determined in supernatants of short term cultured duodenal biopsy samples, serum, and saliva from HIV infected patients (n = 28) and controls (n = 14) by radial immunodiffusion.Results—IgG was increased in the supernatants of short term cultured biopsy samples and saliva from HIV infected patients compared with controls (p<0.01), but IgA and IgM levels were normal. In contrast, both IgG and IgA concentrations in serum were higher in HIV infected patients than in controls (p<0.002). No correlation was found between IgA produced by duodenal biopsy specimens and serum IgA.Conclusion—Abnormalities in mucosal immunoglobulin production in HIV infection were suprisingly small, indicating that specific secretory immunity rather than quantitative immunoglobulin production may be impaired. However, increased production of IgG could contribute to mucosal inflammation by complement activation. Our findings of normal mucosal IgA production and the lack of correlation between serum and mucosal IgA argues against an intestinal origin for the increased serum IgA levels in HIV infected patients.

scholarly journals Explaining risk factors for drug-resistant tuberculosis in England and Wales: contribution of primary and secondary drug resistance

2004 ◽  
Vol 132 (6) ◽  
pp. 1099-1108 ◽  
Author(s):  
S. J. CONATY ◽  
A. C. HAYWARD ◽  
A. STORY ◽  
J. R. GLYNN ◽  
F. A. DROBNIEWSKI ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multidrug Resistance ◽  
Hiv Infection ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Isoniazid Resistance ◽  
Drug Resistant Tuberculosis ◽  
England And Wales ◽  
Resistance Risk ◽  
Resistant Tuberculosis

Drug-resistant tuberculosis can be transmitted (primary) or develop during the course of treatment (secondary). We investigated risk factors for each type of resistance. We compared all patients in England and Wales with isoniazid- and multidrug-resistant tuberculosis in two time-periods (1993–1994 and 1998–2000) with patients with fully sensitive tuberculosis, examining separately patients without and with previous tuberculosis (a proxy for primary and secondary drug-resistant tuberculosis). Patients with previous tuberculosis smear positivity and arrival in the United Kingdom <5 years were strongly associated with multidrug resistance and isoniazid resistance. In patients with no previous tuberculosis HIV infection, residence in London and foreign birth were risk factors for multidrug resistance, and non-white ethnicity, residence in London and HIV infection for isoniazid resistance. Risk factors for each type of resistance differ. Elevated risks associated with London residence, HIV positivity, and ethnicity were mainly seen in those without previous tuberculosis (presumed transmission).

scholarly journals Clinical case of meningovascular syphilis in combination with HIV infection

2019 ◽  
Vol 0 (3) ◽  
Author(s):  
S. Ya. Kyryliuk ◽  
T. I. Nehrych ◽  
Ya. Ye. Sanotskyi
Keyword(s):  
Hiv Infection ◽  
Clinical Case ◽  
Meningovascular Syphilis

scholarly journals The Potential of eCD4-Ig, Delivered by Adeno-Associated Virus (AAV) Vector as a Novel Vaccine for HIV/AIDS Infection

2021 ◽  
Vol 2 (2) ◽  
pp. 133-9
Author(s):  
Ghea Mangkuliguna
Keyword(s):  
Hiv Infection ◽  
Immunoglobulin G ◽  
Rhesus Macaques ◽  
Therapeutic Vaccine ◽  
Hiv Vaccine ◽  
Aav Vector ◽  
Adeno Associated Virus ◽  
Dependent Cell ◽  
Hiv Aids

Background: HIV/AIDS has already become one of the world's major health issues taking its toll on millions of lives each year. Developing an HIV vaccine with excellent efficacy has become a global urgency that must be addressed immediately. Recently, researchers have successfully developed a more self-like molecule which is a fusion protein between human CD4 domains and immunoglobulin G (IgG) Fc with a CCR5-mimetic sulfopeptide in the carboxy terminus. This molecule, eCD4-Ig, targets only the conserved regions of HIV Env and thus demonstrated the most remarkable potency and breadth so far. By using adeno-associated virus (AAV) vector, eCD4-Ig’s long-term expression in vivo can be achieved. Objectives: Evaluate the efficacy of AAV-eCD4-Ig as both preventive and therapeutic vaccine for HIV/AIDS infection. Methods: A systematic literature study was conducted with the database in PubMed, ScienceDirect, and Proquest. No time and language restriction were applied. Discussion: This review shows that eCD4-Ig eliminates HIV-infected cells through neutralization and antibody-dependent cell-mediated cytotoxicity (ADCC). Moreover, eCD4-Ig is also capable of preventing HIV infection in vivo. Delivered with AAV, eCD4-Ig is maintained stably at both protective and therapeutic levels, as well as gives robust protection for rhesus macaques for almost a year long through a single injection. Conclusion: This study offers evidences that AAV-eCD4-Ig appears to have the potential to be an effective vaccine to prevent HIV infection. Keywords: AAV, AIDS, eCD4-Ig, HIV, vaccine   Latar Belakang: Pengembangan vaksin HIV yang efektif menjadi sangat penting mengingat tingginya angka kematian yang ditimbulkan oleh HIV/AIDS. Beberapa tahun terakhir, peneliti berhasil menemukan sebuah molekul yang tersusun atas domain CD4 manusia, immunoglobulin G (IgG) Fc, dan sulfopeptida yang menyerupai CCR5. Molekul yang dinamakan eCD4-Ig ini menargetkan area konservatif dari HIV Env sehingga berpotensi untuk menjadi vaksin HIV yang efektif. Ekspresi eCD4-Ig akan dipertahankan menggunakan Adeno-associated Virus Vector (AAV). Tujuan: Evaluasi efektivitas AAV-eCD4-Ig sebagai vaksin untuk HIV/AIDS. Metode: Penelitian dilakukan dengan melakukan tinjauan pustaka dari beberapa database jurnal, yakni PubMed, ScienceDirect, dan Proquest tanpa ada batasan waktu dan bahasa. Pembahasan: eCD4-Ig membunuh sel-sel yang terinfeksi HIV melalui proses netralisasi dan antibody-dependent cell-mediated cytotoxicity (ADCC). eCD4-Ig juga memberikan perlindungan terhadap infeksi HIV. Ekspresi AAV-eCD4-Ig sangat stabil untuk dosis protektif dan terapeutik, sekaligus melindungi rhesus macaques dari infeksi HIV selama hampir 1 tahun lamanya hanya dengan sekali injeksi. Kesimpulan: AAV-eCD4-Ig memiliki potensi yang menjanjikan untuk menjadi vaksin HIV yang efektif bagi seluruh penderita HIV/AIDS di seluruh dunia. Kata Kunci: AAV, AIDS, eCD4-Ig, HIV, vaksin

scholarly journals Epidemiological analysis of factors influencing the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis

2021 ◽  
Vol 11 (5) ◽  
pp. 989-993
Author(s):  
A. V. Kukurika ◽  
E. I. Yourovskaya ◽  
V. A. Lyakhimets
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Viral Hepatitis ◽  
Combined Treatment ◽  
Miliary Tuberculosis ◽  
Multidrug Resistant ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Viral Hepatitis C ◽  
Cd4 Lymphocytes

The epidemiological significance of combined forms of especially dangerous infections has not been studied enough, unlike mono-infections. Currently, there is a tendency towards an increase in the incidence of multidrug-resistant tuberculosis. The formation of severe forms of the disease is caused by other widespread infections, such as chronic viral hepatitis and HIV. Polymorbid conditions distort the clinical manifestations of tuberculosis, reduce the effectiveness of anti-tuberculosis therapy and worsen the prognosis of the disease. Risk factors among patients in this category need analysis to carefully monitor patients and ensure infection control. Objective is to analyze the factors affecting the course of multidrug-resistant tuberculosis in HIV-infected patients with concomitant viral hepatitis. Materials and methods. Cases of the combined pathology of multiresistant tuberculosis, HIV infection and viral hepatitis with a dominant diagnosis of tuberculosis are analyzed. Results and discussion. The influence of the immunological status on the course of combined pathology was revealed. Since all the patients under study had clinical stage 4 of HIV infection, tuberculosis developed as an opportunistic infection. Severe immunosuppression (CD4 < 200 cells/ml) contributed to the progression of the generalized tuberculosis process. Long-term immunodeficiency was an unfavorable factor; in the overwhelming majority of cases, antiretroviral therapy was prescribed only after tuberculosis was detected. The dependence of the clinical form of tuberculosis on the level of CD4-lymphocytes was noted: isolated lesion of the chest organs prevailed in patients with a level of CD4-lymphocytes more than 200 cells/ml, generalization of TB process — with CD4 less than 200 cells/ml. Patients with miliary tuberculosis had a higher mortality rate compared to patients with other clinical forms, regardless of antiretroviral therapy. It was revealed that socially disoriented young people with viral hepatitis C prevailed in the structure of patients, the prevalence of which was due to the influence of aggravating factors, such as alcohol and drug abuse, and stay in prisons. Against the background of combined treatment, there was no significant effect of viral hepatitis on the course of polymorbid conditions and the effectiveness of the therapy.

Multidrug-resistant tuberculosis in patients with HIV infection in the CIS countries

2021 ◽  
Vol 3_2021 ◽  
pp. 78-83
Author(s):  
Zimina V.N. Zimina ◽  
Kravchenko A.V. Kravchenko ◽  
Kulabukhova E.I. Kulabukhova ◽  
Suvorova Z.K. Suvorova ◽  
Pokrovskaya А.V. Pokrovskaya ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Multidrug Resistant ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Cis Countries
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