The association between HIV and antituberculosis drug resistance

Abstract

In the UK, HIV is considered to be a risk factor for antituberculosis drug resistance. Evidence of the association is, however, inconclusive and there are few population-level data. The present study investigated the association in England and Wales during the period 1999-2005.National tuberculosis surveillance data for adults were matched to HIV/AIDS reports. Unmatched cases were assumed to be HIV-negative. Separate analyses were conducted on new tuberculosis cases and those with a previous diagnosis. Logistic regression was used for univariable and multivariable analyses.There were 1,657 previously diagnosed cases (80 HIV-positive) and 18,130 new cases (1,156 HIV-positive). Isoniazid resistance was found in 8.1% of previously diagnosed cases and 6.6% of new cases, and multidrug resistance in 2.8% and 0.7%, respectively. There was no evidence of an association between HIV and antituberculosis drug resistance among previously diagnosed cases. Among new cases, there was no overall association between HIV and isoniazid or multidrug resistance after adjusting for confounding factors. White HIV-positive patients were more likely to have multidrug resistance, but numbers were small. In contrast to some previous studies, this large, up-to-date study provides little evidence that HIV co-infected tuberculosis patients in England and Wales are at increased risk of firstline antituberculosis drug resistance.

Isoniazid-Resistant Tuberculous Meningitis, United States, 1993–2005

“…However, we did not see an association between HIV and initial isoniazid resistance among persons with known HIV status (p = 0.73), and the strength of the association between foreign birth and initial isoniazid resistance was not significantly modified by the presence of HIV infection. Similar to our findings, a lack of association between HIV and isoniazid resistance was seen in all cases of TB in the United States (with 13% known HIV positive) and the United Kingdom (with 5% known HIV positive) ( 5 , 8 ). …”

Tuberculosis among migrant populations in the European Union and the European Economic Area

“…Foreign-born individuals represented >60% of notified TB-HIV co-infected cases in Belgium, England and Wales, France and the Netherlands (in England and Wales the percentage exceeded 80%) while lower percentages, of ∼30%, were reported in Italy and Spain. 33 In Denmark, nearly 60% of TB-HIV co-infected cases were migrants.…”

Clinical and epidemiological profiles of individuals with drug-resistant tuberculosis

“…The study area is the headquarters of the eighth São Paulo Administrative Region, which is an important centre for healthcare and other services (SMPGE 2013). Healthcare services are provided to the local population and the region of the states mentioned above and the state of Goiás ( Gazetta et al 2007 ). This region is also a distribution centre of illicit drugs to other states and it has a high rate of acquired immune deficiency syndrome (AIDS), which influences TB co-infections ( Santos et al 2009 ).…”