Poliakova Svitlana, Al Sabaileh Shrouq, Narbutova Tamara, Lytvynenko Marianna, Balazh Olesia
Department of Internal Medicine, Al-Balqa Applied University, Al-Salt, 19117 Jordan.
Department of Pathology and Forensic Medicine, Al-Balqa Applied University, Al-Salt, 19117 Jordan.
Virusdisease. 2024 Mar;35(1):1-10. doi: 10.1007/s13337-023-00855-6. Epub 2024 Feb 1.
Tuberculosis remains a major global health concern, especially in the context of emerging drug-resistant strains and the high prevalence of HIV/AIDS. Understanding the pathomorphologic changes associated with DRTB and its coinfection with HIV/AIDS is crucial for designing effective diagnostic, preventive, and therapeutic interventions. The objectives of this study were to assess the pathomorphologic changes, investigate lung function and blood circulation, and explore risk factors and clinical predictors associated with cor pulmonale in patients with DRTB and DRTB/HIV/AIDS co-infections. The study included 72 patients, with 28 having isolated DRTB and 44 having DRTB/HIV/AIDS co-infections. Microscopic examination of lung tissue samples from isolated DRTB patients revealed fibrous and productive changes with inflammatory infiltration. Histological examination of the myocardium in these patients showed hypertrophy and diffuse cardiosclerosis. Patients with DRTB/HIV/AIDS co-infections exhibited extensive destructive changes in lung tissue, along with dystrophy of cardiomyocytes and focal lymphohistiocytic infiltration in the myocardium. The frequency of cor pulmonale formation was significantly higher in the co-infection group (22.7%) compared to the isolated DRTB group (10.7%). Histological samples suggested that co-infection with HIV/AIDS exacerbates myocardial damage caused by DRTB. This research demonstrates the distinct pathomorphologic changes observed in the lung tissue and myocardium of patients with isolated DRTB and DRTB/HIV/AIDS co-infections. The study findings support the association between co-infection and increased risk of cor pulmonale development. Understanding the mechanisms underlying these differences will help identify potential therapeutic targets to mitigate myocardial damage in patients with DRTB and its co-infection.
结核病仍然是全球主要的健康问题，尤其是在出现耐药菌株以及艾滋病毒/艾滋病高流行率的背景下。了解与耐多药结核病及其与艾滋病毒/艾滋病合并感染相关的病理形态学变化对于设计有效的诊断、预防和治疗干预措施至关重要。本研究的目的是评估病理形态学变化，调查肺功能和血液循环，并探索耐多药结核病患者以及耐多药结核病/艾滋病毒/艾滋病合并感染患者中与肺心病相关的危险因素和临床预测指标。该研究纳入了72名患者，其中28名患有单纯耐多药结核病，44名患有耐多药结核病/艾滋病毒/艾滋病合并感染。对单纯耐多药结核病患者的肺组织样本进行显微镜检查发现有纤维性和增殖性变化以及炎症浸润。对这些患者心肌的组织学检查显示有肥大和弥漫性心肌硬化。耐多药结核病/艾滋病毒/艾滋病合并感染患者的肺组织出现广泛的破坏性变化，同时伴有心肌细胞营养不良和心肌局灶性淋巴细胞组织细胞浸润。与单纯耐多药结核病组（10.7%）相比，合并感染组肺心病形成的频率显著更高（22.7%）。组织学样本表明，与艾滋病毒/艾滋病合并感染会加剧耐多药结核病所致的心肌损伤。本研究证明了在单纯耐多药结核病患者以及耐多药结核病/艾滋病毒/艾滋病合并感染患者的肺组织和心肌中观察到的不同病理形态学变化。研究结果支持合并感染与肺心病发生风险增加之间的关联。了解这些差异背后的机制将有助于确定潜在的治疗靶点，以减轻耐多药结核病患者及其合并感染时的心肌损伤。
