INTERFERON-GAMMA ADMINISTRATION IN THE COMPLEX TREATMENT OF PULMONARY TB PATIENTS WITH DRUG RESISTANCE

Resistance of Mycobacterium tuberculosis (MTB) to TB drugs is a major factor of TB progression and patient death. TB caused by drug resistant strains commonly has protracted progressive course. The immune response to TB plays a significant role in the disease outcome. Interferons have the unique ability to protect the organism from various intracellular pathogens. Interferon-gamma (INF-γ) is an interferon with pronounced immunomodulatory activity, which allows using it as an important component of immunotherapy for a wide range of diseases. Ingaron® is an affordable domestic drug based on recombinant INF-γ used in practical health care. Objective: to assess effectiveness of IFN-γ administration in the complex treatment of newly diagnosed pulmonary TB patients with multiple drug resistance (MDR). Materials and methods. We studied 50 patients with newly diagnosed pulmonary TB and established MDR aged 18–55 years. The patients were divided into two groups: 25 patients (main group) received TB treatment containing IFN-γ (Ingaron®, Farmaklon, Russia), and 25 patients (comparison group) received TB treatment without any immunotherapy. The matched-comparison group was based on gender, age, clinical form of pulmonary TB, and drug resistance pattern. In both groups infiltrative pulmonary TB accounted for 56%, advanced (more than 3 segments affected) TB accounted for 76%, and destructive processes accounted for 86% of cases. Results. In the main group more pronounced dynamics was observed after 2 months of treatment – disappearance of intoxication symptoms (59%) and respiratory syndromes (73%), normalization of inflammatory shifts in blood tests (70%), sputum conversion (84%), small cavity (up to 2.5 cm) closure (50%) (χ2 = 6.2; p < 0.05), and activation of the immune response (χ2 = 7; p < 0.05). Positive effect of IFN-γ contributed to significant shortening of inpatient treatment. Conclusion. The administration of IFN-γ in combination with TB drugs improves effectiveness of treatment of newly diagnosed patients with drug-resistant pulmonary TB.