title: Impact of the growing HIV-1 epidemic on multidrug-resistant tuberculosis control in Latvia.
abstract: Latvia, a country with levels of multidrug-resistant (MDR) TB among the highest in the world, experienced a 58-fold increase in HIV seroprevalence among all persons tested in the country from 1996 through 2001. In addition, HIV seroprevalence among TB cases increased from 0.4% to 1.4%, and among MDR-TB cases from 0% to 5.6% from 1998 through 2001, potentially compromising gains made to date in controlling the country's MDR-TB epidemic. The following will be critical to the future of MDR-TB control in Latvia: containing HIV transmission in the country, particularly among injection drug users who comprised 72% of all HIV cases reported in the country by the end of 2001, as well as 81% of all MDR-TB cases co-infected with HIV; expanding capabilities to more rapidly detect and successfully treat patients with MDR-TB; developing mutual TB control strategies between the National TB and AIDS programs; and continuing to improve institutional infection control measures, particularly in hospitals and prisons where an increasing number of persons infected with HIV come into contact with persons with active MDR-TB.
authors.affiliation: Latvian State Center for Tuberculosis and Lung Diseases, Latvian National Tuberculosis Program, Riga, Latvia.
authors.forename: I
authors.initials: I
authors.lastname: Morozova
authors.forename: V
authors.initials: V
authors.lastname: Riekstina
authors.forename: G
authors.initials: G
authors.lastname: Sture
authors.forename: C
authors.initials: C
authors.lastname: Wells
authors.forename: V
authors.initials: V
authors.lastname: Leimane
mesh_terms: D003140:Communicable Disease Control; D015897:Comorbidity; D004196:Disease Outbreaks; D018432:Drug Resistance, Multiple; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D015497:HIV-1 / Q000472:pathogenicity*; D006291:Health Policy; D006801:Humans; D017053:Infection Control; D007844:Latvia / Q000453:epidemiology; D011050:Policy Making; D016036:Seroepidemiologic Studies; D019966:Substance-Related Disorders; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*