Patterns of anti-tuberculosis drug resistance among HIV-infected patients in Maputo, Mozambique, 2002-2003

• Published in: The international journal of tuberculosis and lung disease Vol. 9; no. 5; pp. 494 - 500
• Main Authors: NUNES, E. A, DE CAPITANI, E. M, COELHO, E, JOAQUIM, O. A, FIGUEIREDO, I. R. O, COSSA, A. M, PANUNTO, A. C, CARVALHO-RAMOS, M
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01.05.2005; Union internationale contre la tuberculose et les maladies respiratoires
• Subjects: Adult; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial diseases; Biological and medical sciences; CD4 Antigens - blood; Drug Resistance; Female; HIV; HIV Infections - epidemiology; Human bacterial diseases; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Microbial Sensitivity Tests; Middle Aged; Mozambique - epidemiology; Multidrug Resistance; Pharmacology. Drug treatments; Resistance Pattern; Risk Factors; Tuberculosis; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Multidrug-Resistant - blood; Tuberculosis, Multidrug-Resistant - drug therapy; Tuberculosis, Multidrug-Resistant - epidemiology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Mozambique; Africa; Immunopathology; Treatment resistance; Respiratory disease; Retroviridae; AIDS; Mycobacterial infection; Immune deficiency; Lentivirus; Epidemiology; Infection; Virus; Tuberculosis; HIV; Viral disease; drug résistance; Bacteriosis; Antituberculous agent; Human immunodeficiency virus; Antibacterial agent; résistance pattern; multi- drug résistance; Public health
• ISSN: 1027-3719; 1815-7920

SETTING: Two tuberculosis (TB) reference hospitals in Maputo, Mozambique.OBJECTIVES: To assess the pattern of TB drug resistance and its risk factors in human immunodeficiency virus (HIV) patients.DESIGN: Adult HIV-positive patients with TB diagnosed by culture of sputum or bronchial washing were enrolled during 2002-2003. Cultures of 111 patients were tested for rifampicin, isoniazid, streptomycin and ethambutol sensitivity. Chest X-ray, haemoglobin (Hb), total lymphocyte and CD4 counts were also performed.RESULTS: Overall resistance to any drugs was found in 18% and multidrug-resistant TB (MDR-TB) in 9%. New cases of TB accounted for 62% of the studied group. Drug resistance in this subgroup was 13% compared with 26.3% in the previously treated subgroup, and MDR-TB was 5.8% vs. 15.8%. All patients presented Hb levels <9 g/dl and total lymphocyte counts <1200/μl. CD4 counts were significantly low in the drug resistance subgroup, with levels mostly <100/μl. Cavities on X-ray were seen only in drug-sensitive patients. No risk factors for drug resistance were detected.CONCLUSIONS: Overall observed drug resistance was 18%, and MDR-TB 9%. Previously treated patients had high drug resistance (26.3%) and MDR-TB (15.8%).