Declining Prevalence of Drug-Resistant Tuberculosis among HIV/Tuberculosis Co-Infected Patients Receiving Antiretroviral Therapy(cid:31)
Somnuek Sungkanuparph MD *, Boonchuay Eampokalap MSc**, Suthat Chottanapund MD**, Supeda Thongyen BEd**, Weerawat Manosuthi MD**
Affiliation : (cid:31) The abstract of this study was presented in the 27th Annual Congress of the European Society of Mycobacteriology, London, UK, 2006; O15 * Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok ** Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi
Background : Drug-resistant tuberculosis (DR-TB) is a serious threat in developing countries where the
prevalence of both HIV and TB are high. Antiretroviral therapy (ART) has been more accessible in these
countries. The present study aimed to determine the impact of ART on the prevalence of DR-TB among HIV/TB
co-infected patients.
Materials and Methods : A retrospective cohort study was conducted among HIV-infected patients with culture-
proved TB from 1999 to 2004. Susceptibilities of Mycobacterium tuberculosis to antituberculous drugs and
rate of ART use were studied.
Results : There were 225 patients, mean age 35.8 years, 72.4% male and median CD4 44 cells/mm3. Patients
who had received ART increased from 18.5% in 1999 to 92.1% in 2004 (p<0.001). The prevalence of DR-TB
in the years 1999 and 2004 were 48% and 7.9%, respectively (p<0.001). The prevalence of isoniazid- and
rifampicin-resistance significantly declined in 2004 when compared with those in 1999 (p<0.05).
Conclusion : The declines in the prevalence of DR-TB, INH- and RFP-resistance in HIV/TB co-infected patients
are possibly attributable to the use of ART. In addition to the survival benefit from ART in HIV-infected
patients, increasing use of ART among HIV-infected patients may eliminate DR-TB in this population.
Keywords : HIV, Tuberculosis, Drug resistance, Prevalence, Antiretroviral therapy
