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HIV infection and primary resistance to antituberculosis drugs in Abidjan, Côte d'Ivoire
M M Braun1, J O Kilburn, R W Smithwick
1Division of HIV/AIDS, Centers for Disease Control, Atlanta, GA 30333.
Objective:
To determine the prevalence of Mycobacterium tuberculosis resistance to antituberculosis drugs, and to relate this resistance to HIV serologic status.
Design:
Cross-sectional prevalence study.
Setting:
The two major outpatient tuberculosis clinics in Abidjan, Côte d'Ivoire, West Africa.
Patients:
Sixty individuals with newly diagnosed pulmonary tuberculosis and sputum smears positive for acid-fast bacilli.
Main Outcome Measures:
HIV serologic status and in vitro testing for susceptibility of M. tuberculosis isolates to antituberculosis drugs.
Results:
M. tuberculosis was isolated from 82% (49 out of 60) of sputum specimens. Thirty-five per cent (17 out of 49) were obtained from HIV-seropositive and 65% (32 out of 49) from HIV-seronegative patients. There was no statistically significant difference in the proportion of resistant isolates from HIV-seropositive versus HIV-seronegative patients, although the relatively small sample size limited power. Of the total number of isolates, 17% were resistant to isoniazid; resistance was less to streptomycin (7%), rifampin (2%), pyrazinamide (0%), and ethambutol (0%). Eighteen and 21% of mycobacterial isolates from HIV-seropositive and HIV-seronegative individuals, respectively, were resistant to one or more of these drugs.
Conclusions:
Surveys of this type are useful in planning and evaluating tuberculosis preventive therapy in individuals with dual infection.