DRUG-INDUCED LIVER INJURY IN HIV-INFECTED PATIENTS WITH ACTIVE TUBERCULOSIS: COMPARATIVE LABORATORY CHARACTERIZATION
Introduction. Co-infection with human immunodeficiency virus (HIV) and tuberculosis constitutes specific diagnostic and therapeutic problems and creates a significant burden on the health care system. Two microorganisms Mycobacterium tuberculosis and human immunodeficiency virus potentiate each other, accelerating the deterioration of immunological functions and lead to premature death in the absence of treatment. According to numerous data, tuberculosis is the direct cause of death in an average of 30% of patients with human immunodeficiency virus. Tuberculosis and the human immunodeficiency virus have profound effects on the immune system because they are able to suppress the host's immune responses.
The aim is to identify drug–induced liver lesions in a cohort of patients with human immunodeficiency virus infection and pulmonary tuberculosis.
Materials and methods. A prospective study, the study included 150 patients with human immunodeficiency virus with and without active tuberculosis. All patients underwent physical and laboratory examination. Statistical processing was performed using IBM SPSS Statistics 29.0.2.0.
Results. The patients were divided into three groups: The first group (I) included patients with HIV infection (n=31), the second (II) - with pulmonary tuberculosis (n=55); the third group (III) included patients with HIV tuberculosis (n=64)). In all groups, gender, age and laboratory indicators were assessed and their comparative analysis was carried out. At the next stage, the number of cases of drug-induced liver damage was assessed and their structure was presented.
Conclusions 1. The incidence of hepatotoxicity in group III (59.3%) was higher than in group I (22.5%) and II (43.6%).
2. ALT levels were higher in men of group III 45.0 (34.0; 66.0) compared to group I 36.0 (24. 75; 45.0) (p=0.015).
3. In male patients of group III, ALT and AST indicators were higher compared to similar indicators in patients of group II, ALT(III) - 45.0 (34.0; 66.0) and ALT(II) (34.0 (17.0; 45.0), respectively, p = 0.008; AST(III) - 48.0 (33.0; 78.0) and AST(II) 36.0 (22.0; 45.0), respectively, p=0.049).
The hemoglobin level was lower in patients of group III 110.0 (96.0; 120.0) compared to the same indicator in patients of group II - 130.0 (100.0; 145) diseases.0), respectively, p = 0.022);
4. Clinical signs such as cough, shortness of breath, and weakness were more often observed in patients of group III compared to groups I and II.
5. The average age of women in group III was 40.0 (37.0; 44.5), respectively, younger compared to the age of women in group I (51.0 (45.0; 53.5), p = 0.034).
Matin Abdul1,2, https://orcid.org/0000-0003-1757-9920
Igor G. Nikitin1, https://orcid.org/0000-0003-1699-0881
Saule A. Alieva3, https://orcid.org/0000-0001-5098-9206
Umit T. Zheldibaeva3, https://orcid.org/0000-0002-8915-3972
Aigerim E. Kasymkan3, https://orcid.org /0000-0002-0114-5397
Saltanat M. Adilgozhina3, https://orcid.org/0000-0002-8408-7363
Oxana A. Yurkovskaya3, https://orcid.org/0000-0002-6251-5574
1 Federal State Educational Institution of Higher Education "Russian National Research Medical University named after N.I. Pirogov" of the Ministry of Health of the Russian Federation, Moscow, Russian Federation;
2 National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Ministry of Health of the Russian Federation, Moscow, Russian Federation;
3 NCJSC “Semey Medical University”, Semey, Republic of Kazakhstan.
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Abdul M., Nikitin I.G., Alieva S.A., Zheldibaeva U.T., Kasymkan A.E., Adilgozhina S.M., Yurkovskaya O.A. Drug-induced liver injury in HIV-infected patients with active tuberculosis: comparative laboratory characterization // Nauka i Zdravookhranenie [Science & Healthcare]. 2024. Vol.26 (6), pp. 64-71. doi 10.34689/SH.2024.26.6.008Похожие публикации:
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