Abstract:
Treatment of the patients with multidrug-resistant tuberculosis (MDR-TB)/HIV coinfection in a state of severely suppressed
immune system remains unsatisfactory. Methods: The study involved 52 HIV-positive patients with MDR-TB and CD4+ lymphocyte
cells below 50 cells/μCL. Patients in control group (Group 1) and in basic group (Group 2) received standard treatment with second-line
antituberculosis agents and antiretroviral agents. In addition, the patients in basic group were treated by immunoglobulin G (IgG) intravenously.
Immunological diagnostics with the determination of the level of lymphocytes subgroups (CD3+, CD4+, CD8+, CD4+/CD8+) was carried
out using an AQUIOS™ CL flow cytometry device at the beginning and after 3–20 months of treatment. Statistical analysis was performed
using the Statistica 10.0 software (Stat. Soft Inc., USA). Results: In the patients of Group 2, the absolute number of CD3+ and CD4+
cells at the end of the 20th month of the treatment normalized in 26.9% (absolute amount) and 42.3% (relative amount) of subjects, while
in Group 1, this indicator remained below the normal level (P < 0.05). The addition of IgG into standard therapy caused normalization of
CD8+ count in 76.9% of patients, while in the control group-only in 46.2% of patients (P < 0.05). Conclusions: The administration of IgG
in combination with standard anti-tuberculosis and antiretroviral therapy (ART) contributes to the normalization of the cellular immunity
status in patients with MDR-TB/HIV coinfection and severe immunosuppression and allows you to start ART earlier than in patients with
single standard therapy.
