Bedaquiline in the complex treatment of HIV-associated respiratory tuberculosis

Abstract

Introduction. The continued decline in the number of patients shedding multidrug-resistant mycobacteria (MDR MDR), which has continued since 2018, determines the priority of measures to improve the effectiveness of treatment of newly diagnosed patients, including HIV-associated tuberculosis, with the mandatory inclusion of new anti-tuberculosis drugs in the treatment regimens of patients. drugs.Aim. To evaluate the efficacy and safety of bedaquiline in the complex treatment of patients with HIV-associated respiratory tuberculosis.Materials and methods. In the prospective study was included 60 patients with newly diagnosed HIV-associated respiratory tuberculosis, randomized into 2 groups: group 1 – 30 patients who received bedaquiline in the combination of anti-tuberculosis drugs; group 2 – 30 patients who received therapy without the addition of bedaquiline. Bacterial excretion was detected in all patients of the 1st and 2nd groups, the MBT drug sensitivity test confirmed the presence of pre-XDR MBT. Patients in both study groups received antiretroviral therapy. The follow-up period for patients was 12 months.Results. In the group of patients treated with bedaquiline, higher treatment results were noted both in terms of the criterion “closing of decay cavities” (by 14.7%) (p > 0.05) and by the criterion “cessation of bacterial excretion” (by 23.3%) ((p <0.05).Conclusions. The high clinical efficacy and safety of the use of bedaquiline in the complex treatment of patients with HIV-associated respiratory tuberculosis has been demonstrated. The data obtained make it possible to recommend the use of bedaquiline in the treatment of patients with newly diagnosed HIV-associated tuberculosis, isolating MBT with pre-XDR, to increase the effectiveness of the main course of chemotherapy, prevent the amplification of MBT drug resistance and develop extensive MBT drug resistance.