PURPOSE: To assess the frequency of drug- resistance between Pulmonary TB patients with HIV and otherwise healthy patients, and to compare the data with our previously compiled results from 1995-1998.
METHODS: We retrospectively reviewed the medical records of 238 patients with Pulmonary TB at our tuberculosis clinic from 1999 to 2007,(137 males, 101 females, age range 21-64 years, mean age 43 yrs.) There were 30 patients with, and 208 patients without HIV. All patients were adequately treated under directly observed therapy with anti-TB medications. Induced sputum samples were collected and AFB smear examinations and cultures were performed. Only culture- positive cases were included in this study.
RESULTS: Of 30 patients with HIV, 2 (7%) patients had multi-drug resistant TB. In the control group of 208 patients, 6 (3%) had multi- drug resistant TB. A total of 8 patients were found to have drug-resistant TB. Of 8 patients with drug resistant TB, two patients were HIV positive and six were HIV negative. All patients were multi drug resistant to INH, Rifampin, Ethambutol, Streptomycin and Pyrazinamide. Our previous study, reporting data from 1995-1998, showed that 28% patients with HIV had drug resistant TB, compared to 11% without HIV. Unlike previous study, our current study showed that all patients with drug-resistance had multi-drug resistance.
CONCLUSION: Multi-drug resistant TB remains more frequent among patients with HIV compared with those without HIV.In our clinic patients, the overall frequency of multi-drug resistant TB declined in HIV patients as compared with our previous study.
CLINICAL IMPLICATIONS: Treatment of TB in HIV patients must take multi-drug resistance into consideration.
DISCLOSURE: Ashraf Rashid, None.