Concurrent Liver Lesions in Patients with HIV-Associated Tuberculosis: Approaches to Therapy

The objective : to evaluate efficacy of treatment of concurrent (viral and drug-induced) liver injuries in patients with HIV-associated tuberculosis using a multicomponent solution for infusions containing succinic acid. Subjects and Methods . The prospective comparative study included 122 patients with HIV-associated tuberculosis and concurrent chronic hepatitis C and B, distributed in 3 groups depending on the clinical and biochemical activity of (viral and drug-induced) liver injuries and the nature of therapy. Group 1 included 48 patients with minimal activity of concurrent liver injury, Group 2 included 38 patients, and Group 3 included 36 patients with moderate clinical and biochemical activity. Patients in Groups 1 and 2 received intravenous administration of the solution of inosine + meglumine + methionine + nicotinamide + succinic acid (Remaxol, OOO NTFF POLYSAN) for 10 days, in Group 3, patients had detoxification therapy (glucose-saline solutions, sterofundin) and ursodeoxycholic acid. Results . Against the background of infusions of the solution of inosine + meglumine + methionine + nicotinamide + succinic acid in patients of Groups 1 and 2 there was a more pronounced decrease of ALT in 3.6-3.8 times vs. 1.9; AST – in 2.6-2.7 times vs. 2.4; TB – in 3.7 times vs. 1.6; DB – in 3.3 times vs. 1.8; GGT – in 5.7 times vs. 4.9 in Group 3. Conclusion . The obtained results demonstrate the efficacy of the solution of inosine + meglumine + methionine + nicotinamide + succinic acid in treatment of concurrent (viral and drug-induced) liver injuries with minimal and moderate clinical and biochemical activity in patients with HIV-associated tuberculosis.