ERS Respiratory Channel

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Abstract

The aim of the study: to determine the prognostic impact of the polymorphism of glutathione-S-transferase genes on the efficiency of treatment of comorbidity diabetes mellitus and multidrug-resistant tuberculosis.

Subject. We have examined 100 patients with multidrug-resistant tuberculosis (MDR-TB) and diabetes mellitus.

Methods. Polymorphism GSTM1 and GSTM1 areas were isolated using complex multi PCR for M. Arana et all (1996).

Results. Patients with pulmonary MDR-TB and diabetes mellitus who are carriers of the wild alleles (GSTM1 + / GSTT1 +) experienced the bacterioexcretion termination more frequently with the 120th dose by 19,60%; (p = 0,061) and 240th doses by 48.71% (p=0.001), respectively. With null genotype in haplotypes (GSTM1+/GSTT1 0/0, GSTT1+/GSTM1 0/0, GSTT1 0/0 / GSTM1 0/0), the frequency of bacterioexcretion at a dose of 120 was lower by 44,2 % (p < 0.001) with a high probability of the forecast for ineffective treatment of comorbidity diabetes mellitus and multidrug-resistant tuberculosis in 68.74 %.

Conclusions: The deletion in the promotive area of both genes (GSTT1 0/0 / GSTM1 0/0) increases the risk of no effect of antituberculosis therapy by 17 times [OR = 24,50, 95% CI OR: 2,18-142 64, p = 0.009]. The presence of GSTT1 + / GSTM1 0 / 0 isoform in haplotype reduces the chances of effective treatment of MDR-TB [OR=0,07, 95%CI OR: 0,09-0,57, ?=0,002 and OR=0,37, 95%CI OR: 0,14-0,97, ?=0,04].

Abstract

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