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Year : 2021  |  Volume : 10  |  Issue : 2  |  Page : 122-128

The Impact of IgG administration on the cellular immunity status in the patients with multidrug-resistant tuberculosis/HIV with CD4 + lymphocyte cells below 50 cells/ μl<

1 Department of Phthisiopulmonology, Odesa National Medical University, Odessa, Ukraine
2 Department of Pharmacology and Pharmacognosy, Odesa National Medical University, Odessa, Ukraine

Correspondence Address:
Petro Antonenko
Department of Pharmacology and Pharmacognosy, Odesa National Medical University, Valihovsky Lane, 2, Odesa 65082
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmy.ijmy_21_21

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Background: 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

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