[The specific features of the course of pulmonary tuberculosis in young Tuvinians in relation to some antigens of the HLA complex].
The study covered 127 new-onset pulmonary tuberculosis patients aged 18-30 years. Disseminated, focal, and infiltrative tuberculosis were found in 10.2, 22, 46.5, respectively and caseous pneumonia were present in 21.3%. Lung cavities were detectable in 92 patients and bacterial excretion was in 90% patients, Mycobacterium tuberculosis strains susceptible to all anti-tuberculous drugs were revealed in 10% of cases; monoresistant, polyresistant, and multidrug resistant strains were found in 6.7, 34.4, and 48.9%, respectively. Chemotherapy was performed in accordance with Order No. 109 issued by the Ministry of Health of the Russian Federation on March 21, 2003. Following 12 months of therapy, sustained cessation of bacterial excretion and closure of lung cavity could be achieved in 49.6% of the patients and a decelerated trend in the specific process with the a high proportion of progressive tuberculosis was noted in 50.3%. Immunogenetic studies have shown a positive correlation of HLA-B27, Cw4, and the specificity of HLA-DRB1*13 with the extent of the tuberculous process and the severity of lung tissue damages. If a patient with tuberculosis had these genetic markers, the specific process could reliably take a severer form, with the involvement of 1 lobe or more in both lungs and with cavitation. In addition, HLA-17 and the specificity of HLA-DRB1*15 were, on the contrary, associated with the milder course of tuberculosis and the less extent of the specific process.
Kyzyl-Oll
M M
MM
Pospelov
A L
AL
Kordicheva
S Iu
SIu
Soroko-Novitskaia
A N
AN
Pospelov
L E
LE
Mishin
V Iu
VIu
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005006:Ethnicity; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D011379:Prognosis; D012426:Russia / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000208:ethnology / Q000276:immunology*; D055815:Young Adult
D000995:Antitubercular Agents; D006680:HLA Antigens