The use of plasmapheresis and intravenous laser blood irradiation in treatment of patients with newly diagnosed tuberculosis at the late stages of HIV infection
This article presents an overview of the current domestic and foreign literature on the problems of treatment of newly diagnosed tuberculosis in patients with late stages of HIV infection. The urgency of the problem, peculiarities of the clinical course and treatment of tuberculosis, the principles of antiretroviral therapy in the combination of tuberculosis and HIV infection are considered. It has been established that long-term chronic (или “long term” или “chronic”) tuberculosis intoxication, as well as aggressive antituberculosis therapy, lead to disruption of metabolic processes, hypercatabolism, intoxication, and development of hypercoagulable syndrome. At the same time, data is provided on the toxic effects of antiretroviral therapy. Treatment of adverse reactions begins with detoxification and antihistamine therapy followed by the addition of vitamin therapy, antioxidants, antihypoxants, hepatoprotectors, anabolic agents, and enterosorbents. Various methods of pathogenetic therapy are of great interest, including extracorporal hemocorrection (plasmapheresis) and intravenous laser irradiation of blood (ILIB). Plasmapheresis (PA) allows the effective and short time normalization of homeostasis indices as well as reduction or elimination of intoxication effects, toxic and allergic reactions, hence increasing the effectiveness of basic therapy. Course of PA in patients with common forms of tuberculosis (3-5 procedures, with an interval of 2-3 days, removal of 20-25% of the volume of circulating plasma and replacement with crystalloid solutions in combination with hydroxyethyl starches) allows the elimination of symptoms of intoxication, increases tolerance of the organism to chemotherapy, and suppresses undesirable side effects. The method of quantum therapy (ILIB) is based on the effect of quantum energy on blood directly in the vascular bed. As the result photo bio logical influence of ILIB, all body systems are activated to correct the existing disorders. This is manifested to a great extent in tissues suffering from oxygen deficiency, since it is in these areas the metabolism increases and the processes of tissue reparation are activated. ILID helps for activation of white blood cell function, phagocytosis, synthesis of antibodies, interferon, and in general, improves the immune status.