Patterns of anti-tuberculosis drug resistance among HIV-infected patients in Maputo, Mozambique, 2002-2003.
METHODS
Two tuberculosis (TB) reference hospitals in Maputo, Mozambique.


OBJECTIVE
To assess the pattern of TB drug resistance and its risk factors in human immunodeficiency virus (HIV) patients.


METHODS
Adult HIV-positive patients with TB diagnosed by culture of sputum or bronchial washing were enrolled during 2002-2003. Cultures of 111 patients were tested for rifampicin, isoniazid, streptomycin and ethambutol sensitivity. Chest X-ray, haemoglobin (Hb), total lymphocyte and CD4 counts were also performed.


RESULTS
Overall resistance to any drugs was found in 18% and multidrug-resistant TB (MDR-TB) in 9%. New cases of TB accounted for 62% of the studied group. Drug resistance in this subgroup was 13% compared with 26.3% in the previously treated subgroup, and MDR-TB was 5.8% vs. 15.8%. All patients presented Hb levels < 9 g/dl and total lymphocyte counts < 1200/microl. CD4 counts were significantly low in the drug resistance subgroup, with levels mostly < 100/microl. Cavities on X-ray were seen only in drug-sensitive patients. No risk factors for drug resistance were detected.


CONCLUSIONS
Overall observed drug resistance was 18%, and MDR-TB 9%. Previously treated patients had high drug resistance (26.3%) and MDR-TB (15.8%).
Nunes
E A
EA
Departamento de Medicina, Universidade Eduardo Mondlane, Maputo. pedro.bete@tvcabo.co.mz
De Capitani
E M
EM
Coelho
E
E
Joaquim
O A
OA
Figueiredo
I R O
IR
Cossa
A M
AM
Panunto
A C
AC
Carvalho-Ramos
M
M
D000328:Adult; D015704:CD4 Antigens / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009073:Mozambique / Q000453:epidemiology; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*
D015704:CD4 Antigens