Changes in CD4+ T-cells and HIV RNA resulting from combination of anti-TB therapy with Dzherelo in TB/HIV dually infected patients

Lyudmila G Nikolaeva¹, Tatyana V Maystat¹, Lilia A Masyuk², Volodymyr S Pylypchuk³, Yuri L Volyanskii⁴, Galyna A Kutsyna⁵

¹Kharkov Regional AIDS Prophylaxis and Prevention Center, Kharkov Medical Academy of Postgraduate Education, Kharkov, Ukraine; ²Jovtnevsky Correctional Colony No.17, State Department of the Penitentiary of Ukraine in Kharkov Region, Kharkov, Ukraine; ³Ekomed LLC., Kiev, Ukraine; ⁴I.I. Mechnikov Institute of Microbiology and Immunology, Kharkov, Ukraine; ⁵Luhansk Regional AIDS Center and Luhansk State Medical University, Luhansk, Ukraine

Abstract: The open-label, phase II clinical trial of antituberculosis therapy (ATT) with or without oral immunomodulator Dzherelo (Immunoxel) was conducted in TB/HIV coinfected, antiretroviral therapy naïve patients to evaluate the effect on CD4 T-lymphocyte counts and viral load. The arm A (n = 20) received isoniazid (H); rimfapicin (R); pyrazinamide (Z); streptomycin (S); and ethambutol (E), and arm B (n = 20) received 50 drops of Dzherelo twice per day in addition to HRZSE. After 2 months in 90% of Dzherelo patients the population of absolute CD4 T-cells expanded by an average of 71.2% (from 174 to 283 cells/µl; P = 0.00003), but declined in ATT-alone patients (182 to 174; P = 0.34). The ratio between CD4/CD8 cells deteriorated in 80% of individuals in arm A (1.213 > 0.943; P = 0.002), but improved in the same proportion of patients in arm B (1.244 > 1.536; P = 0.007). The number of total CD3+ lymphocytes rose from 728 to 921 cells in arm B (P = 0.025) whereas it fell from 650 to 585 cells in arm A (P = 0.25). The viral load, as measured by plasma RNA-PCR, decreased in 70% of Dzherelo recipients (2.174 > 1.558 copies/ml; P = 0.002), but increased in 70% of HRZSE only receivers (1.907 > 2.076 copies/ml; P = 0.03). Dzherelo has a favorable effect on the immune status and viral burden in TB/HIV patients when given as an immunomodulating adjunct to ATT.

Keywords: dual infection, herbal, immunotherapy, MDR-TB, multi-drug resistant, Mycobacterium tuberculosis, phytotherapy, Ukraine, XDR-TB