Application of the Specific Imunoglobulin Therapy in The HIV Infected Persons with Chronic Toxoplasmosis
Hryzhak, I. H.
- Publisher: Ivano-Frankivsk National Medical University
Galician Medical Journal
HIV-infection; toxoplasmosis treatment; azithromycin; immunoglobulin against Toxoplasma Gondii
The objective of the research was to study the effectiveness of complex treatment of HIV-infected patients with moderate chronical toxoplasmosis using azithromycin and human immunoglobulin against Toxoplasma Gondii. The patietns were not at the AIDS stage.Materials and methods of the research. 60 patients with I, II and III clinical stage of the HIV-infection who had moderate chronic toxoplasmosis were under observation. Moderate form of toxoplasmosis was not considerated as AIDS indicator disease. The immunoenzyme method was used to determine titers of specific anti-Toxoplasma IgG and IgM, and IL-2, IL-4, IL-10, TNF-2a, IgM, IgA, IgG.The І group of patients (30 individuals) received azithromycin inside for 21 days in a dose of 1.0 g/day, and the second group (30 persons) received azithromycin for 21 days in a dose of 1.0 g / day and human immunoglobulin against Toxoplasma Gondii every second day number 5 in a dose of 3.0 ml intramusculary.Results. Substantial symptoms of the toxoplasmosis included swollen lymh nodes (90.0%), low-grade fever (63.33%), neurocirculatory dystonia (86.67%), moderate hepato-splenic syndrome (58.33%), weakness and fatigue (81.67%), muscle pain (36.67%), myocarditis (6.67%), chorioretinitis (3.33%).Both groups of patients had positive clinical changes after treatment. The conditional score of toxoplasmosis activity (CSAT) was applied to illustrate the effectiveness of two treatment regimens more clearly. CSAT was the average percentage of six symptoms (fever, neurocirculatory dystonia, weakness, muscle pain, myocarditis, chorioretinitis). Before treatment CSAT constituted 46.39±6,4% and after treatment it decreased significantly to 16.67±6.8% only in patients who received azithromycin and human immunoglobulin against Toxoplasma Gondii (P<0.05).Increased levels of IL-2, IL-4, IL-10, TNF-2a were detected in all the patients before treatment. After course of treatment with azithromycin and immunoglobulin the levels of IL-2 and TNF-2a decreased to normal in contrast to the patients who received only azithromycin.ConclusionsApplication of the specific human immunoglobulin against Toxoplasma Gondii increased the effectiveness of treatment of moderate chronic toxoplasmosis with the use of azithromycin in the HIV-positive patients not at AIDS stage. The effectiveness of treatment manifested in the decrease in toxoplasmosis symptoms complex.The activity of proinflammatory Interleukin-2 and TNF-2a and anti-inflammatory Interleukins-4 and 10 increased in the HIV-infected persons with toxoplasmosis. After the treatment with azithromycin and human immunoglobulin against Toxoplasma Gondii the levels of IL-2 and TNF-2a decreased indicating the completion of immune inflammation process.