Effects of chemotherapy on the immunological characteristics of patients with primary destructive pulmonary tuberculosis.

An investigation of 142 patients with primary destructive pulmonary tuberculosis was carried out using several immunological tests to estimate the quantitative and functional status of the T- and B-lymphocyte systems and the specific cell-mediated and humoral immunity. It was shown that the status of the immune system, and that of the specific antituberculosis immunity in particular, were dependent on the severity of the tuberculosis process. There were indications that the immune status largely determined the extent of the infiltrative lesions, as well as the course of the disease. In patients with no pronounced defects in cell-mediated immunity in general and in specific immunity in particular, the time needed for sputum samples to become bacterially negative and for the cavities to close was reduced, especially in cases where the initial bacterial excretion was not heavy and the degree of the infiltration was not severe. Defects in the immune system impeded the clinical progress of the tuberculosis patients; moreover, complete clinical recovery in such cases was delayed and there was a higher incidence of reactivation of the disease during the main chemotherapy course as well as of recurrence of the disease at a later date.