The interpretation of the key points of the Expert Consensus on Immunotherapy for Tuberculosis (2022 edition)

doi:10.19983/j.issn.2096-8493.20230035

Abstract

Abstract:

The Global Tuberculosis Report 2022 showed a simultaneous increase of the numbers of people with tuberculosis disease, drug-resistant TB, or tuberculosis deaths in 2021, which had posed a serious challenge to the realization of the goal of End TB Strategy. Triple infections of TB/HIV/COVID-19 has hit heavily on the global TB control efforts. Therefore, It’s still a long way for us to achieve the global goal of ending TB as scheduled. Novel changes of the global tuberculosis epidemic situation constitutes new challenges for the management of tuberculosis. Although great progress has been made in shortening the course of treatment and improving the medication effectiveness for treating both drug-susceptible and drug-resistant tuberculosis, these new shorter all-oral treatment regimens still have not been rolled out globally, the adverse reactions of the first-line and second-line anti-tuberculosis drugs are still relatively high, while the immunotherapy for tuberculosis may provide a new opportunity for the current dilemma of chemotherapy. Thus, we tried to interpret the key points of the Expert Consensus on Immunotherapy for Tuberculosis (2022 edition) with the hope that it may play a positive role in increasing the treatment success rate of tuberculosis therapy.

Key words: Tuberculosis, Immunotherapy, Consensus development conferences as topic

CLC Number:

R52
R392

Gao Wenwan, Guo Jianqiong, Li Tongxin, Han Mei, Yan Xiaofeng, Yang Song, Tang Shenjie. The interpretation of the key points of the Expert Consensus on Immunotherapy for Tuberculosis (2022 edition)[J]. Journal of Tuberculosis and Lung Disease , 2023, 4(3): 194-197. doi: 10.19983/j.issn.2096-8493.20230035

Figures/Tables 1

生物制剂名称	适用对象	给药频次和使用剂量
母牛分枝杆菌菌苗	药物敏感肺结核患者	抗结核治疗第1天,第1、2、3周或1个月后应用均可。随后给药方法:每3~4周1次,共治疗6次左右。每次将本品1瓶(含母牛分枝杆菌菌体蛋白22.5μg),用1.0ml灭菌注射用水稀释摇匀后,于臀部肌肉深部注射
	复治及难治性肺结核患者	在敏感肺结核基础可酌情延长治疗时间,治疗可多达24次。每次将本品1瓶(含母牛分枝杆菌菌体蛋白22.5μg),用1.0ml灭菌注射用水稀释摇匀后,于臀部肌肉深部注射
草分枝杆菌疫苗	免疫功能低下的肺结核和肺外结核患者	极低浓度型(0.172mg/L)、低浓度型(1.72mg/L)、中浓度型(17.2mg/L)、高浓度型(172mg/L)。深部肌肉注射,使用前充分摇匀;一般从极低浓度型开始,极低浓度型或低浓度型1支(每次1支,每周1次)、中浓度型1支(每次1支,每2~3周1次)、高浓度型1支(每次1支,每8~12周1次)。疗程2~6个月。也可根据病情,遵医嘱使用。本品同其他药物及疫苗是相容的(疫苗注射后间隔2周再注射本品为佳)
重组人IL-2	免疫功能下降的敏感肺结核和耐药结核病患者	大剂量为100万~1000万U,小剂量为10万~20万U;大剂量不良反应较大,一般多主张用小剂量。可采用每日或隔日疗法,10万~45万U/d,皮内注射,连续10~30d为1个疗程,间歇2周后可重复使用,使用时间2~4个月
IFN-γ	无IFN-γ分泌或反应缺陷的结核病、复治和重症结核病患者,特别是伴空洞的耐药结核病患者	皮下注射,100万U/次,每周3次,疗程可为6个月;雾化吸入,100万U或500μg/次,每周3次,疗程6个月。100万U/次,肌肉注射,1次/d,共1个月,然后3次/周,总疗程可为6个月
IFN-α	同IFN-γ	雾化吸入,3万U,3次/周,疗程2个月,可适当延长至6个月。肌肉注射,100万U/次,每2天1次,疗程可为6个月
卡介苗多糖核酸	初治、复治和耐多药肺结核患者	肌肉注射,每次1ml,隔日1次或每周3次,3个月为1个疗程,共治疗1~3个疗程。或按说明书使用
胸腺肽α1和胸腺五肽	各种免疫功能低下的肺结核患者	胸腺肽α1:1.6mg/次,皮下注射,每周2次,每次间隔3~4d,疗程2~6个月。胸腺五肽,1mg/次,皮下注射,隔日1次,疗程6个月;也可肌肉注射或静脉注射,1mg/d,疗程3个月;胸腺五肽肠溶胶囊:5mg/次,口服,2次/d,疗程6个月

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