[Evaluation of the efficacy of antiparasitic drugs in the treatment of concurrent parasitic diseases in patients with HIV infection and in those with pulmonary tuberculosis].

The efficacy of albendazole (400 mg taken once), mebendazole (100 mg taken once), and metronidazole (0.5 g thrice daily for 7 days) was evaluated when treating ascariasis, enterobiosis, and blastocystosis, respectively, in patients with HIV infection and in those with pulmonary tuberculosis. Metronidazole-resistant lambliasis was treated with exdisten (5 mg four times for 10 days) in 30.4% of the patients with HIV infection and in 43.3% of those with tuberculosis. Most HIV infected patients received antiretroviral therapy (ARVT). All the tuberculosis patients took isoniazid, ethambutol, pyrazinamide, rifampicin, and streptomycin. Efficiency was monitored by triple coproscopy at an interval of 5-7 days and by additional examinations using the method of Ritchii et al. There was parasitological cure (decreased infection rate for blastocystosis) and clinical improvement as positive changes in symptoms, such as nausea, weakness, headache, weight loss, and others, in all the patients with concomitant ascariasis, enterobiosis, and lambliasis. ARVT and antituberculosis drugs were observed to be better tolerated in all cases.

[Blastocystis hominis and nonpathogenic enteric protozoa in patients with pulmonary tuberculosis and those with HIV infection].

Blastocystis hominis and nonpathogenic enteric protozoa were diagnosed in 300 patients with pulmonary tuberculosis mainly of its infiltrative form and 500 with Stages II and III HIV infection; the patients received antituberculosis therapy (ATT) and antiretroviral therapy (ART), respectively. Control groups included 200 Tashkent dwellers and 350 patients with various noninfectious diseases of the gastrointestinal tract. Triple coproscopy was made. B. hominis was significantly more frequently detected in patients with pulmonary tuberculosis and those with HIV infection than in healthy individuals: in 53.6 +/- 2.9, 42.2 +/- 2.2, and 18.0 +/- 2.5, respectively (P < 0.01). Only did the tuberculosis or HIV-infected patients show a high intensity of B. hominis infection, which was accompanied by recurring diarrhea and nausea. The high activity of alanine aminotransferase and aspartate aminotransferase was observed in 20% of the patients with tuberculosis + blastocytosis; that of alkaline phosphatase was seen in 25%. The tuberculosis or HIV-infected patients were more frequently found to have Chylomastix mesnili, Jodamoeba butschlii, and Endolimax nana. The specific features of intestinal colonization seem to reflect changes in local immunity; the drugs included into ATT and ART have no substantial effects on the viability of protozoa.

[The efficacy of ecdystene versus metronidazole in the treatment of lambliasis].

Ecdisten, the drug designed on the basis of the phytoecdisteroid ecdisterone isolated from Rhaponticum carthamoides, was used in the treatment of first diagnosed (primary) and persistent (resistant to traditional lambliacides) lambliasis. A control group received metronidazole. Daily parasitological monitoring of lamblia elimination while treating with ecdisten in a daily dose of 20 mg for 10 days indicated the absence of lamblia in 70% of the patients with primary lambliasis on days 3 to 5; in the remaining 30%, parasitic elimination was accomplished on days 6-7 of treatment. In the patients with persistent lambliasis, the parasites were eliminated in 43.2% of cases on days 4-5 and in 56.6% on days 6-10. Metronidazole just on the second day of therapy caused parasitic elimination in 28.6% of the patients. All the patients were freed from lamblia within 5 days. Improvement occurred more rapidly with ecdisten treatment; immunological normalization was seen when ecdisten was used. Seven-ten-day course of ecdisten is sufficient for the treatment of primary lambliasis; when persistent lambliasis is treated, its course should be prolonged. If required, the course may be repeated, by increasing the daily dose.

[Intestinal parasitic diseases in HIV-infected patients in Uzbekistan].

Intestinal parasitic diseases were diagnosed in 100 HIV-infected patients at different stages of disease (its asymptomatic form, persistent generalized lymphoadenopathy, pre-AIDS, and AIDS) (Group 1), 100 Tashkent residents (Group 2), and 349 patients with gastrointestinal diseases, allergic dermatoses, and skin depigmentation foci (Group 3). The HIV-infected patients were found to have virtually all parasites, such as Giardia lamblia, Cryptosporidium parvum, Chilomastix mesnili, Entamoeba coli, Iodamoeba butschlii, Entamoeba histolytica/dispar, Endolimax nana, Blastocystis hominis, Enlerobius vermicularis, Ascaris lumbricoides, Hymenolepis nana, detectable in the population of Tashkent. The highest infestation with intestinal protozoa, including nonpathogenic amoebas and helmninths, was found in Groups 1 and 3. However, in all the forms of HIV infection, the infestation with E. histolytical/dispar was 10 times greater than that in Groups 2 and 3 (1% and 0.8%, respectively). G. lamblia was detected in 16, 21, and 45.2% in Groups 1, 2, and 3, respectively. In all the HIV-infected patients, the content of CD8 lymphocytes was increased, but that of CD20 lymphocytes was normal. Parasites were detectable with different levels of CD4 lymphocytes, but C. parvum was found only if its count was > 200/ml. In the HIV-infected patients, the hyperproduction of IgE was caused mainly by helminths rather than protozoa. In these patients, the increased level of IgE was also noted in the absence of parasites.

[Ecdysten in the treatment of giardiasis]. / Ekdisten v lechenii liamblioza.

The drug ecdisten as tablets is the natural compound ecdisteron was extracted from Rhaponticum carthamoides (Willd.) Jljin. Ecdisten was tested in the treatment of 32 and 3 patients with persistent and acute giardiasis, respectively. A ten-day course of ecdisten, 5 mg 3 or 4 times a day, resulted in a clinical and parasitological recovery in 22 (68.7%) and 3 patients, respectively. After the reuse of a ecdisten course in 4 patients with persistent giardiasis wherein its initial dose was increased, recovery was achieved in 3 cases, the efficacy of the agent was 78.1%. Ecdisten should be used to treat giardiasis, in its chronic pattern or resistance to conventional giardicial agents.

[Early and late E-rosette-forming neutrophils in persistent lambliasis]. / Rannie i pozdnie E-rozetkoobrazuiushchie neitrofily pri persistiruiushchem liamblioze.

The E-rosette-forming capacity of neutrophils and T-lymphocyte counts in the peripheral blood of 21 patients suffering from persistent giardiasis (PG) were found. A control group included 29 healthy persons. The patients with PG showed a significant increase in the count of early and late E-rosette-forming neutrophils along with a substantial decrease in the count of T-lymphocytes, which is indicative of an inflammatory process located mainly in the gallbladder. It is concluded that according to the neutrophil counts, immunodeficiency may not be regarded as a factor predisposing to PG.

[The characteristics of HLA antigen distribution among patients with persistent lambliasis]. / Osobennosti raspredeleniia HLA-antigenov u bol'nykh persistiruiushchim liambliozom.

Fifty patients suffering from persistent giardiasis and 257 healthy persons from Uzbekistan were examined. HLA-typing was carried out by the Terasaki microlymphocytotoxicity technique. The patients with persistent giardiasis were characterized as a significant prevalence of HLA-B5, HLA-B14, HLA-DR3, DR4, DR7 and haplotypes HLA-A9-B5 and A1-B5. These haplotypes and HLA antigens can be considered as markers of predisposition to persistent giardiasis.