efficacy of interferon-alpha in the treatment of multidrug resistant tuberculosis

ABSTRACT

Tuberculosis is a major cause of infectious disease modality all over the world. Multidrug resistant tuberculosis [MDR-TB] is a major problem in the management of tuberculosis. With recent advances in understanding the immunopathogenesis of tuberculosis, the use of various cytokine therapies has been suggested. The objective of this study was to evaluate the efficacy of parenteral INF-alpha for treating MDR-TB patients. To conduct the study, 12 MDR- TB patients hospitalised in the clinical mycobacteriology ward of Massih Daneshvari hospital were selected randomly between October 2000 and March 2001. All had chest involvement in radiography, so they were smear and culture positive on two occasions. All had at least resistance to isoniazid and rifampin in antibio gram. They were divided in two groups. One group received INF-alpha; [3,000, 000U, three times a week, subcutaneously] in addition to anti-TB drugs, and the other group received only anti -TB medications as control group. Results indicate that the mean [ +/- SD] degree of sputum smear positivity at the beginning of therapy was 2.4 +/- 0.89 in the case group and 2 +/- 0.89 in the control group which showed no significant difference [p 0.132]. Also, at the beginning of our study, there was no significant difference in the degree of sputum culture positivity between the two groups. At the end of the 8th week, all cases became smear and culture negative, but all control subjects remained smear and culture positive [p= 0.017]. At the end of the 6th month; however, only two cases remained smear negative, one remained culture negative and the rest became positive. All control subjects had positive culture results [p 0.693]. We conclude that cytokines have at least temporary effect on disease remission and can be used as adjunctive therapy