Efficacy of combined antiviral and anti-tuberculosis therapy in the treatment of initial pulmonary tuberculosis patients with positive HBV-DNA and the correlation of hepatic function with IFN-γ and SSS scores
Objective To analyze the efficacy of combined antiviral and anti-tuberculosis therapy in the treatment of initial pulmonary tuberculosis patients with positive hepatitis B virus deoxyribonucleic acid(HBV-DNA)and the cor-relation of interferon-γ(IFN-γ)and semi-quantitative scoring system(SSS)score with hepatic function.Methods A total of 120 initial pulmonary tuberculosis patients with positive HBV-DNA who were admitted to Rugao Hospital Affilia-ted to Nantong University from March 2022 to March 2023 were selected.According to the random number table method,they were divided into two groups(n=60):a control group and an observation group.The control group underwent con-ventional anti-tuberculosis therapy,while the observation group received antiviral therapy in addition to anti-tuberculosis therapy.All the patients were treated for six months.Both groups were compared for clinical efficacy,including lesion absorption,negative conversion of sputum culture,and HBV-DNA negative conversion,as well as hepatic function and inflammatory factors levels before and after treatment.The levels of IFN-γ,HBV-DNA and SSS scores at different time points(before treatment,and 1,3 and 6 months after treatment)were compared between the two groups.The Pearson correlation coefficients of hepatic function with IFN-γ and SSS scores were calculated.Results The observation group showed higher proportions of patients with lesion absorption,negative conversion of sputum culture and HBV-DNA nega-tive conversion than those in the control group(P＜0.05).After treatment,increased levels of ALT,AST and TBiL and decreased levels of IL-2,IL-6,IL-8 and TNF-were seen in the two groups,compared with those before treatment,where the changes in the observation group were less obvious than those in the control group(P＜0.05).Compared with those before treatment,the levels of IFN-γ increased after treatment for 1,3 and 6 months,where the levels of IFN-γ in the observation group were lower than those in the control group,with statistical differences(P＜0.05).Compared with those before treatment,the levels of HBV-DNA in the observation group gradually decreased after treatment for 1,3,and 6 months,and those in the control group increased,where the levels of HBV-DNA in the observation group were lower than those in the control group(P＜0.05).Compared with those before treatment,the levels of SSS scores increased after treatment for 1,3 and 6 months,where the levels of SSS scores in the observation group were lower than those in the con-trol group,with statistical differences(P＜0.05).According to Pearson correlation analysis,IFN-γ levels were positive-ly correlated with ALT,AST,TBiL and SSS scores in initial pulmonary tuberculosis patients with positive HBV-DNA(r＞0,P＜0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusions Combined antiviral and anti-tuberculosis therapy can effectively improve the clinical outcome of initial pulmonary tuberculosis patients with positive HBV-DNA,reduce inflammation and HBV-DNA levels,avoid he-patic damage,and stabilize hepatic function,without increases in the risk of adverse reactions.
pulmonary tuberculosishepatitis B virusanti-virusanti-tuberculosishepatic functioninterferon-γsemi-quantitative scoring system score
NETL
NSTL
万方数据
维普
