Effectiveness and Safety of New Chemotherapy Regimens in Patients with HIV-associated MDR TB and Viral Hepatitis C
https://doi.org/10.58838/2075-1230-2024-102-6-82-89
Abstract
The objective: to study the effectiveness and safety of new chemotherapy regimens at the end of the intensive phase in the patients suffering from multiple drug resistant tuberculosis (MDR TB), concurrent HIV infection (HIV), and chronic hepatitis C (HCV).
Subjects and Methods. The effectiveness and safety of MDR TB treatment regimens containing bedaquiline, linezolid, delamanid, and clofazimine in various combinations were studied in 68 patients with the triple infectious disease MDR TB/HIV/HCV. The control group included 64 patients receiving treatment with the regimens free of these drugs.
Results. Bacteriological effectiveness was achieved in all patients. In the group of new drugs, the timing was shorter: culture conversion after taking 30 doses was registered in 70.6% versus 43.8% of patients in the control group. Positive radiographic changes such as decreased focal infiltrative shadows, were noted in 41.1% versus 25% of patients, cavity healing was observed in 18.1% versus 5.1% of patients, respectively. The incidence of adverse reactions (ARs) was higher in the control group (90.6% vs. 52.9%). In both groups, the most common adverse event outcome was discontinuation of one anti-tuberculosis drug (69% vs. 42%).
Conclusion. Chemotherapy regimens containing new anti-tuberculosis drugs are more effective and have a more favorable safety profile.
About the Authors
A. V. Kukurika
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health
Russian Federation
Russian Federation
Anastasia V. Kukurika - Specialist of Socially Important Infections Center
Build. 2, 4 Dostoevskiy St., Moscow, 127473
Phone: + 7 (495) 681-11-66
A. B. Peregudova
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health
Russian Federation
Russian Federation
Alla B. Peregudova - Candidate of Medical Sciences, Head of Infectious Diseases Department
Build. 2, 4 Dostoevskiy St., Moscow, 127473
Phone: + 7 (495) 681-11-66
L. E. Parolina
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health
Russian Federation
Russian Federation
Lyubov E. Parolina - Doctor of Medical Sciences, Professor, Head of Training Center
Build. 2, 4 Dostoevskiy St., Moscow, 127473
Phone: + 7 (495) 681-11-66
T. V. Pyanzova
Kemerovo State Medical University, Russian Ministry of Health
Russian Federation
Russian Federation
Tatiana V. Pyanzova - Doctor of Medical Sciences, Associate Professor, Head of Phthisiology Department
22A Voroshilova St., Kemerovo, 650029
Phone: + 7 (3842) 73-48-56
E. O. Bryukhacheva
Kemerovo State Medical University, Russian Ministry of Health
Russian Federation
Russian Federation
Ekaterina O. Bryukhacheva - Assistant of Phthisiology Department
22A Voroshilova St., Kemerovo, 650029
Phone: + 7 (3842) 73-48-56
O. V. Serdyuk
Republican Clinical TB Hospital
Russian Federation
Russian Federation
Oksana V. Serdyuk - Head of Pulmonary Tuberculosis Department for Patients with Multiple Drug Resistance
104a Iliicha Ave., Donetsk, 283032
Phone: + 7(856) 300-12-89
References
1. WHO steps up the Director-General’s flagship initiative to combat tuberculosis. (In Russ.) Available: https://www.who.int/ru/news/item/23-03-2023-who-steps-up-the-director-general-s-flagship-initiative-to-combat-tuberculosis Accessed October 01, 2024
2. Giller D.B., Marel I.I., Elinelis I.I., Koroev V.V., Kesaev O.Sh., Giller B.D., Scherbakova G.V. Surgical treatment of tuberculous empyema in children. Pirogov Russian Journal of Surgery, 2019, no. 8, pp. 22-28. (In Russ.) https://doi.org/10.17116/hirurgia201908122
3. Klinicheskie rekomendatsii Tuberkulez u detey. [Clinical guidelines on tuberculosis in children]. Rossiyskoe Obschestvo Ftiziatrov Publ., 2022, 111 p. Available: Https://cr.minzdrav.gov.ru/recomend/507_2Accessed October 01, 2024
4. Opanasenko N.S., Tereshkovich A.V. Surgical treatment of pulmonary tuberculosis with multiple drug resistance in children. Khirurgiya Detskogo Vozrasta, 2018, vol. 61, no. 4, pp. 61-65. (In Russ.)
5. Ovsyankina E.S., Gubkina M.F., Panova L.V. Feasibility of the concept for respiratory tuberculosis chemotherapy in children and adolescents (literature review and comments). Tuberculosis and Lung Diseases, 2019, vol. 97, no. 11, pp. 41-45. (In Russ.) https://doi.org/10.21292/2075-1230-2019-97-2-20-25
6. Panova L.V., Ovsyankina E.S., Bagirov M.A., Poluektova F.A., Khiteva A.Yu., Krushinskaya E.A. Pharmacotherapy and surgical treatment of lately diagnosed advanced destructive pulmonary tuberculosis in adolescents. Infectious Diseases (Infektsionnye Bolezni), 2019, vol. 17, no. 3, pp. 97-104. (In Russ.) https://doi.org/10.20953/1729-9225-2019-3-97-104
7. Sposob opredeleniya dlitelnosti khimioterapii posle khirurgicheskogo lecheniya tuberkuleza organov dykhaniya u detey i podrostkov. [The method for determining the duration of chemotherapy after surgical treatment of respiratory tuberculosis in children and adolescents]. Patent RF no. 626509 dated July 28, 2017.
8. Sposob opredeleniya dlitelnosti khimioterapii tuberkuleza organov dykhaniya s mnozhestvennoy i shirokoy lekarstvennoy ustoychivostyu MBT u detey i podrostkov. [The method for determining the duration of chemotherapy for respiratory tuberculosis with multidrug-resistant and extensively drug-resistant MBT in children and adolescents]. Patent RF no. 2680972 dated March 01, 2019.
9. Sposob opredeleniya dlitelnosti khimioterapii tuberkuleza organov dykhaniya u detey i podrostkov s vpervye opredelennoy iz operatsionnogo materiala mnozhestvennoy i shirokoy lekarstvennoy ustoychivostyu mikobakteriy tuberkuleza. [The method for determining the duration of chemotherapy for respiratory tuberculosis in children and adolescents with multiple and extensively drug resistant Mycobacterium tuberculosis isolated for the first time from surgical specimens]. Patent RF no. 2711519 dated January 17, 2020.
10. Sposob opredeleniya dlitelnosti khimioterapii tuberkuleza organov dykhaniya u detey i podrostkov pri poluchenii testa lekarstvennoy chuvstvitelnosti na etape khimioterapii. [The method for determining the duration of chemotherapy for respiratory tuberculosis in children and adolescents when receiving a drug sensitivity test at the stage of chemotherapy]. Patent RF no. 2711520 dated January 17, 2020.
11. Sposob formirovaniya skhem ukorochennykh rezhimov khimioterapii tuberkuleza organov dykhaniya s mnozhestvennoy i shirokoy lekarstvennoy ustoychivostyu MBT u detey starshego vozrasta i podrostkov. [The method for compilation of short-course chemotherapy regimens for treatment of respiratory tuberculosis with multiple and extensive drug resistance in older children and adolescents]. Patent RF no. 2748957 dated June 02, 2021.
12. Global tuberculosis report 2023. Geneva, World Health Organization, 2023. License: CC BY-NC-SA 3.0 IGO Available: https://www.who.int/teams/global-tuberculosis-programme/tb-reports Accessed September 05, 2024
13. Garcia-Prats A., Hoddinott G., Howell P., Hughes J., Jean-Philippe P., Kim S. et al. Children deserve simple, short, safe, and effective treatment for rifampicin-resistant tuberculosis. Lancet Infect Dis., 2023, no. 25, pp. 349-353. https://doi.org/10.1016/S1473-3099(23)00349-3
14. WHO consolidated guidelines on tuberculosis. Module 5: management of tuberculosis in children and adolescents. WHO, 2022, 128 р. Available: https://www.who.int/publications/i/item/9789240046764 Accessed September 05, 2024
Review
For citations:
Kukurika A.V., Peregudova A.B., Parolina L.E., Pyanzova T.V., Bryukhacheva E.O., Serdyuk O.V. Effectiveness and Safety of New Chemotherapy Regimens in Patients with HIV-associated MDR TB and Viral Hepatitis C. Tuberculosis and Lung Diseases. 2024;102(6):82-89. (In Russ.) https://doi.org/10.58838/2075-1230-2024-102-6-82-89
Views:
310
Email this article 