Coinfection ; Ethambutol ; HIV Infections ; HIV ; Humans ; Isoniazid ; Meningoencephalitis ; Methods ; Mortality ; Mycobacterium tuberculosis ; Pyrazinamide ; Rifampin ; Serum ; Sputum ; Tuberculosis ; Tuberculosis, Meningeal ; Tuberculosis, Pulmonary

BACKGROUND: The aim of this study was to investigate the effectiveness of intravenous isoniazid (H) and ethambutol (E) administered in patients with new sputum positive drug-susceptible pulmonary tuberculosis (TB) with tuberculous meningoencephalitis (TM) and human immunodeficiency virus (HIV) co-infection in the intensive phase of treatment. METHODS: Fifty-four patients with TB/TM and HIV co-infection were enrolled for this study. Group 1 comprised of 23 patients treated with E and H intravenously, while rifampicin and pyrazinamide were prescribed orally. Group 2 consisted of 31 patients treated with the first-line anti-TB drugs orally. The concentrations of H and E in blood serum were detected using a chromatographic method. RESULTS: A significant improvement in the clinical symptoms and X-ray signs in patients treated intravenously with H and E was observed and compared to group 2. The sputum Mycobacterium tuberculosis positivity was observed during the second month of the treatment in 25.0% of patients from group 1 and 76.1% of the patients from the control group (p=0.003). In addition, nine patients (39.1%) died up to 6 months when H and E were prescribed intravenously compared with 22 (70.9%) in group 2 (p=0.023). CONCLUSION In TB/TM with HIV, the intravenous H and E treatment was more effective than oral H and E treatment at 2 months of intensive treatment in sputum conversion as well as in clinical improvement, accompanied by significantly higher mean serum concentrations. In addition, the mortality rate was lower in intravenous H and E treatment compared to oral treatment.

BACKGROUND: The aim of this study was to investigate the effectiveness of intravenous isoniazid (H) and ethambutol (E) administered in patients with new sputum positive drug-susceptible pulmonary tuberculosis (TB) with tuberculous meningoencephalitis (TM) and human immunodeficiency virus (HIV) co-infection in the intensive phase of treatment. METHODS: Fifty-four patients with TB/TM and HIV co-infection were enrolled for this study. Group 1 comprised of 23 patients treated with E and H intravenously, while rifampicin and pyrazinamide were prescribed orally. Group 2 consisted of 31 patients treated with the first-line anti-TB drugs orally. The concentrations of H and E in blood serum were detected using a chromatographic method. RESULTS: A significant improvement in the clinical symptoms and X-ray signs in patients treated intravenously with H and E was observed and compared to group 2. The sputum Mycobacterium tuberculosis positivity was observed during the second month of the treatment in 25.0% of patients from group 1 and 76.1% of the patients from the control group (p=0.003). In addition, nine patients (39.1%) died up to 6 months when H and E were prescribed intravenously compared with 22 (70.9%) in group 2 (p=0.023). CONCLUSION In TB/TM with HIV, the intravenous H and E treatment was more effective than oral H and E treatment at 2 months of intensive treatment in sputum conversion as well as in clinical improvement, accompanied by significantly higher mean serum concentrations. In addition, the mortality rate was lower in intravenous H and E treatment compared to oral treatment.

V5 is derived from pooled blood of donors with hepatitis B and C, which was hydrolyzed, autoclaved and foFWHlrtted into ordinary tablets. The principle of V5 action is similar to the first generation hepatitis B vaccine derived from plasma of hepatitis carriers. Preclinical studies have shown that V5 is safe - no acute or chronic toxicity in vitro or animals was seen at 1,882-fold higher doses than recommended once-per-day pill regimen. Safety Phase 1 two-month study has not demonstrated any adverse effects. Several clinical Phase II trials of V5 were conducted in past 5 years since its approval as a biologically active immunomodulator. Post-marketing survey in Mongolia assessed in 240 individuals with hepatitis B and C revealed that levels of liver damage biomarkcrs: ALT; bilirubin and alkaline phosphatase decreased from mean 104.9192 to 63.2 • 51 (P« 0.0001); 14. I±12 to 9.9±7 (P=0.0001); 319±190 to 242±145 (P=0.049), respectively. The efficacy ofV5 based on ALT decrease in each individual was observed in 84.1% of patients. During trial in Ukraine on hepatitis C patients who also had tuberculosis it was accidentally discovered that V5 can clear Mycobacterium tuberculosis. Subsequent trials, including randomized placebo controlled phase II Mai, conducted in over 300 patients with TB has demonstrated that V5 has potent anti-TB activity r4iardless whether patients had drug sensitive TB, MDR-TB or TB with HIV. On average the c'crrance rate was observed in over 85% of TB patients after just one month. Recently wc have slJHed seeing patients with hepatocellular carcinoma who seemed to benefit from V5. The case rcR)rt from one patient will be presented to illustrate this effect. In conclusion. V5 appears to have kfSad spectrum activity against unrelated diseases. This needs to be verified in further clinical studies