Abstract
Tuberculosis remains a major global health concern, especially in the context of emerging drug-resistant strains and the high prevalence of HIV/AIDS. Understanding the pathomorphologic changes associated with DRTB and its coinfection with HIV/AIDS is crucial for designing effective diagnostic, preventive, and therapeutic interventions. The objectives of this study were to assess the pathomorphologic changes, investigate lung function and blood circulation, and explore risk factors and clinical predictors associated with cor pulmonale in patients with DRTB and DRTB/HIV/AIDS co-infections. The study included 72 patients, with 28 having isolated DRTB and 44 having DRTB/HIV/AIDS co-infections. Microscopic examination of lung tissue samples from isolated DRTB patients revealed fibrous and productive changes with inflammatory infiltration. Histological examination of the myocardium in these patients showed hypertrophy and diffuse cardiosclerosis. Patients with DRTB/HIV/AIDS co-infections exhibited extensive destructive changes in lung tissue, along with dystrophy of cardiomyocytes and focal lymphohistiocytic infiltration in the myocardium. The frequency of cor pulmonale formation was significantly higher in the co-infection group (22.7%) compared to the isolated DRTB group (10.7%). Histological samples suggested that co-infection with HIV/AIDS exacerbates myocardial damage caused by DRTB. This research demonstrates the distinct pathomorphologic changes observed in the lung tissue and myocardium of patients with isolated DRTB and DRTB/HIV/AIDS co-infections. The study findings support the association between co-infection and increased risk of cor pulmonale development. Understanding the mechanisms underlying these differences will help identify potential therapeutic targets to mitigate myocardial damage in patients with DRTB and its co-infection.
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Abbreviations
- DRTB:
-
Drug-resistant tuberculosis
- TB:
-
Tuberculosis
- HIV:
-
Human immunodeficiency virus
- AIDS:
-
Acquired immunodeficiency syndrome
- COPD:
-
Chronic obstructive pulmonary disease
- CLAT:
-
Centres de lutte antituberculeuse
- H&E:
-
Hematoxylin and eosin
- FEV1:
-
Forced expiratory volume in one second
- TLC:
-
Total lung capacity
- PH:
-
Pulmonary hypertension
- NT pro-BNP:
-
N-terminal pro-brain natriuretic peptide
References
Ayo Bivigou E, Kombila UD, Kinga A, Akagha Konde C, Boguikouma JD. Isolated chronic right heart failure due to Tuberculosis sequelae: experience of the Libreville University Hospital Center. Arch Cardiovasc Dis Suppl. 2023;15(1):170.
Bar SL, Sayeh N, Ignaszewski AP. Elevated N-terminal pro-brain natriuretic peptide in Mycobacterium tuberculosis pulmonary Infection without myocardial dysfunction. Can J Cardiol. 2009;25(4):223–5. https://doi.org/10.1016/S0828-282X(09)70066-2.
Garrison DM, Pendela VS, Memon J. Cor pulmonale. Treasure Island: StatPearls Publishing; 2022.
Gupta M, Lobo FD, Adiga DS, Gupta AA. Histomorphological pattern analysis of pulmonary Tuberculosis in lung autopsy and surgically resected specimens. Pathol Res Int. 2016;2016: 8132741. https://doi.org/10.1155/2016/8132741.
Guthmann JP, Fraisse P, Bonnet I, Robert J. Active Tuberculosis screening among the displaced population fleeing Ukraine, France, February to October 2022. Eurosurveillance. 2023;28(12):2300155.
Hoon Park H, Kim S, Choi J, Kim KH, Cheon SC, Lee JH, Lee YG, Kim IJ, Cha DH, Hong SB, Lee JH. The application of B-Type natriuretic peptide level of the dyspneic patients: differentiation between cor pulmonale and left ventricular dysfunction. Tuberc Respir Dis. 2003;54(3):320–9. https://doi.org/10.4046/trd.2003.54.3.320.
Ishkuvvatovich BE. Etiology, pathogenesis and pathomorphology of Tuberculosis. J New Century Innov. 2022;1(2):29–35.
Kim MA, Kim SH, Zo JH, Hwangbo B, Lee JH, Chung HS. Right heart dysfunction in post-tuberculosis Emphysema. Int J Tuberc Lung Dis. 2004;8(9):1120–6.
Kornaga SI. Chronical lung heart—the most frequent direct reason of death of lung Tuberculosis patients. Bull Sci Res. 2006;4:77–8.
Li H, Zeng Z, Cheng J, Hu G, Li Y, Wei L, Zhou Y, Ran P. Prognostic role of NT-proBNP for in-hospital and 1-year mortality in patients with acute exacerbations of COPD. Int J Chron Obstruct Pulm Dis. 2020;15:57–67. https://doi.org/10.2147/copd.s231808.
Marcu DTM, Adam CA, Mitu F, Cumpat C, Aursulesei Onofrei V, Zabara ML, Burlacu A, Crisan Dabija R. Cardiovascular involvement in Tuberculosis: from pathophysiology to diagnosis and complications—a narrative review. Diagnostics. 2023;13(3): 432. https://doi.org/10.3390/diagnostics13030432.
Muñoz-Torrico M, Cid-Juárez S, Gochicoa-Rangel L, Torre-Bouscolet L, Salazar-Lezama MA, Villarreal-Velarde H, Pérez-Padilla R, Visca D, Centis R, D’Ambrosio L, Spanevello A, Saderi L, Sotgiu G, Migliori GB. Functional impact of sequelae in drug-susceptible and multidrug-resistant Tuberculosis. Int J Tuberc Lung Dis. 2020;24(7):700–5. https://doi.org/10.5588/ijtld.19.0809.
Patil SV, Toshniwal S, Acharya A, Gondhali G. Cardiac dysfunction in active pulmonary tuberculosis: mysterious facts of TB’s pandora. Electron J Gen Med. 2023;20(2):452.
Protsyuk RG. Tuberculosis in combination with HIV infection. Tuberc Lung Dis HIV Infect. 2020;3(42):92–103.
Rajeev GS. Pulmonary Hypertension in post Tuberculosis pulmonary sequelae: attention needed. Chest J. 2020;157(6):A406. https://doi.org/10.1016/j.chest.2020.05.454.
Raznatovska OM, Siusiuka VH, Fedorec AV, Pyroh AI, Makurina HI. Clinical cases of management and treatment of women with chemoresistant Tuberculosis during pregnancy. Pathologia. 2020;17(1):127–32.
Rosenkranz S, Howard LS, Gomberg-Maitland M, Hoeper MM. Systemic consequences of pulmonary hypertension and right-sided Heart Failure. Circulation. 2020;141(8):678–93. https://doi.org/10.1161/CIRCULATIONAHA.116.022362.
Sampath P, Rajamanickam A, Thiruvengadam K, Palaniappan Natarajan A, Hissar S, Dhanapal M, Thangavelu B, Jayabal L, Murugesan Ramesh P, Devi Ranganathan U, Babu S, Bethunaickan R. Cytokine upsurge among drug-resistant Tuberculosis endorse the signatures of hyper inflammation and Disease severity. Sci Rep. 2023;13:785. https://doi.org/10.1038/s41598-023-27895-8.
Su X, Lei T, Yu H, Zhang L, Feng Z, Shuai T, Gou H, Liu J. NT-proBNP in different patient groups of COPD: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2023;18:811–25. https://doi.org/10.2147/COPD.S396663.
Zhang YW, Wu D, Zhu ZZ, Ou JC, Kong ZC, Zhu WF, Shi QM, Wang M. Analysis of the imaging features and prognosis of pulmonary Tuberculosis complicated with pulmonary embolism. Curr Med Imaging. 2023;20:e310323215270. https://doi.org/10.2174/1573405620666230331082549.
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Poliakova, S., Al Sabaileh, S., Narbutova, T. et al. Pathological findings in respiratory organs and blood circulation in patients with isolated DRTB and DRTB/HIV/AIDS co-infection (according to autopsy data). VirusDis. (2024). https://doi.org/10.1007/s13337-023-00855-6
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DOI: https://doi.org/10.1007/s13337-023-00855-6