2 articles
Pulmonary tuberculosis remains a major cause of morbidity and mortality worldwide. According to data published by the World Health Organization in 2024, a total of 8.2 million people were newly diagnosed with TB in 2023, compared with 7.5 million in 2022, 7.1 million in 2019, and markedly higher than the 5.8 million and 6.4 million in 2020 and 2021, respectively.
The prospective study involved 59 participants before and after treatment: 11 women (18.6%) and 48 men (81.4%). The participants were divided into 2 groups: group L1 – patients with tuberculosis before treatment, and group L2 – patients with tuberculosis after treatment. Serum levels of nitric oxide, malondialdehyde, glutathione reductase, and total antioxidant activity were measured using a spectrophotometric method.
In the study, we demonstrated that nitric oxide and malondialdehyde serum concentrations were non-significantly higher in the L2 group compared with the L1 group. Glutathione reductase activity showed a significant decrease in antioxidant activity in the L2 group, indicating reduced antioxidant capacity. Total antioxidant activity showed a non-significant decrease in the L1 group compared with the L2 group.
The results of the research demonstrated that the administered anti-tuberculosis treatment increased nitric oxide and malondialdehyde levels, and reduced glutathione reductase and total antioxidant activity. This phenomenon indicates the persistence of oxidative stress even after treatment. The levels of nitric oxide, malondialdehyde, glutathione reductase, and total antioxidant activity in patients with pulmonary tuberculosis may serve as biomarkers for monitoring disease progression.
Tuberculosis continues to be the primary cause of death among individuals living with human immunodeficiency virus, with co-infection significantly influencing the clinical course, severity, and outcomes of the disease. Although the interaction between the two conditions is well recognized, regional data from Eastern Europe remain insufficient.
A retrospective, cross-sectional comparative study was carried out in the Republic of Moldova in 2021. A total of 320 patients with newly diagnosed pulmonary tuberculosis were included and divided into two matched groups: the study group consisted of 160 patients with confirmed human immunodeficiency virus co-infection, and the control group included 160 patients without human immunodeficiency virus infection. The groups were comparable in terms of age, sex, residence, and resistance profile of Mycobacterium tuberculosis. Data were collected from national clinical records and analyzed using descriptive statistical methods.
Among 320 patients, those with HIV co-infection had significantly higher rates of generalized TB (28.8% vs. 2.5%; p < 0.0001), subacute onset (71.9% vs. 22.5%; p < 0.0001), and severe/very severe condition at diagnosis (27.4% vs. 10.6%; p = 0.0017). Anemia (58.8% vs. 23.1%; OR = 4.73, p < 0.0001), leukopenia (16.3% vs. 1.3%; OR = 15.33, p < 0.0001), and ESR >60 mm/h (25.0% vs. 5.6%; OR = 5.59, p < 0.0001) were significantly more common in co-infected patients. Bilateral lung lesions were more frequent (65.6% vs. 59.4%), while cavitary destruction predominated in TB-only patients (59.4% vs. 34.4%; p < 0.0001). Smear positivity was lower in the HIV group (38.8% vs. 55.0%; p = 0.0036). Complications (48.1% vs. 20.6%; p < 0.0001) and opportunistic infections (17.5% vs. 0%) were more prevalent in co-infected patients. Mortality was significantly higher among HIV-positive cases (28.1% vs. 6.9%; OR = 5.20, p < 0.0001).
Human immunodeficiency virus infection significantly modifies the clinical presentation of tuberculosis, favoring more severe, atypical, and extrapulmonary forms, along with higher complication rates and mortality. These findings highlight the urgent need for early diagnosis, adapted diagnostic approaches, and integrated treatment strategies in patients with dual infection, particularly in high-burden settings.