Prevalence of rifampicin-resistant Mycobacterium tuberculosis among human-immunodeficiency-virus-seropositive patients and their treatment outcomes

• Published in: Journal of epidemiology and global health Vol. 7; no. 4; pp. 289 - 294
• Main Authors: Vidyaraj, C.K., Chitra, A., Smita, S., Muthuraj, M., Govindarajan, S., Usharani, B., Anbazhagi, S.
• Format: Journal Article
• Language: English
• Published: Dordrecht Elsevier Ltd 01.12.2017; Springer Netherlands; Springer Nature B.V; Atlantis Press; Springer
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antitubercular Agents - therapeutic use; Child; Child, Preschool; Codons; Control programs; Developing countries; Female; Genotypes; HIV; HIV Infections - complications; HIV Infections - microbiology; Human immunodeficiency virus; Humans; Infant; Infant, Newborn; Isoniazid; LDCs; Liquid culture; Male; Middle Aged; Multidrug resistance; Multidrug resistant organisms; Mycobacterium tuberculosis; Mycobacterium tuberculosis - isolation & purification; Pandemics; Prevalence; Research Article; Rifampin; Rifampin - therapeutic use; Sputum; Treatment Outcome; Tuberculosis; Tuberculosis, Multidrug-Resistant - epidemiology; Tuberculosis, Pulmonary - drug therapy; Tuberculosis, Pulmonary - epidemiology; Tuberculosis, Pulmonary - etiology; Young Adult
• ISSN: 2210-6006; 2210-6014; 2210-6006
• DOI: 10.1016/j.jegh.2017.09.002

•The M. tuberculosis culture positivity among the HIV seropositive patients was 39.44%.•The multidrug resistant tuberculosis among HIV seropositive patients was 5.6%.•The cure rate and death rate among the twenty registered cases were 30% and 35% respectively.•High death rate (13, 36.1%, 95% CI [20.8–53.8]) was observed among the patients those who having mutations at 53–533 codons. Multidrug resistant (MDR) and extensively drug resistant tuberculosis (TB) are a threat to the TB control programs in developing countries, and the situation is worsened by the human immunodeficiency virus (HIV) pandemic. This study was performed to correlate treatment outcome with the resistance patterns in HIV-seropositive patients coinfected with pulmonary TB. Sputum specimens were collected from 1643 HIV-seropositive patients and subjected to microscopy and liquid culture for TB. The smear- and culture-positive Mycobacterium tuberculosis isolates were subjected to Genotype MTBDRplus assay version 2.0. The M. tuberculosis culture-positivity rate was 39.44% (648/1643) among the 1643 HIV-seropositive patients and the overall MDR-TB rate was 5.6% (36/648). There were 421 newly diagnosed and 227 previously treated patients, among whom, MDR-TB was associated with 2.9% and 10.57% cases, respectively. The rate of rifampicin monoresistant TB among the cases of MDR-TB was 2.31% (15/648) and the rate of combined rifampicin and isoniazid resistance was 3.24% (21/648). The cure and death rates among the 20 registered cases were 30% (6/20) and 35% (7/20), respectively. Five cases were on treatment and two cases were defaulters among the 20 registered cases. High death rate (13, 36.1%, 95% confidence interval 20.8–53.8) was observed in this study among the patients who had mutations at the 530–533 codons. The present study emphasized the prerequisite to monitor the trend of drug-resistant TB in various mutant populations in order to timely implement appropriate interventions to curb the threat of MDR-TB.