Abstract
Tuberculosis remains a major global health concern, especially in the context of emerging drug-resistant strains and the high prevalence of HIV/AIDS. Understanding the pathomorphologic changes associated with DRTB and its coinfection with HIV/AIDS is crucial for designing effective diagnostic, preventive, and therapeutic interventions. The objectives of this study were to assess the pathomorphologic changes, investigate lung function and blood circulation, and explore risk factors and clinical predictors associated with cor pulmonale in patients with DRTB and DRTB/HIV/AIDS co-infections. The study included 72 patients, with 28 having isolated DRTB and 44 having DRTB/HIV/AIDS co-infections. Microscopic examination of lung tissue samples from isolated DRTB patients revealed fibrous and productive changes with inflammatory infiltration. Histological examination of the myocardium in these patients showed hypertrophy and diffuse cardiosclerosis. Patients with DRTB/HIV/AIDS co-infections exhibited extensive destructive changes in lung tissue, along with dystrophy of cardiomyocytes and focal lymphohistiocytic infiltration in the myocardium. The frequency of cor pulmonale formation was significantly higher in the co-infection group (22.7%) compared to the isolated DRTB group (10.7%). Histological samples suggested that co-infection with HIV/AIDS exacerbates myocardial damage caused by DRTB. This research demonstrates the distinct pathomorphologic changes observed in the lung tissue and myocardium of patients with isolated DRTB and DRTB/HIV/AIDS co-infections. The study findings support the association between co-infection and increased risk of cor pulmonale development. Understanding the mechanisms underlying these differences will help identify potential therapeutic targets to mitigate myocardial damage in patients with DRTB and its co-infection.