Multi-drug resistant TB and HIV in Thailand: overlapping, but not independently associated risk factors.
The HIV and multi-drug resistant tuberculosis (MDR-TB) epidemics are closely linked. In Thailand as part of a sentinel surveillance system, we collected data prospectively about pulmonary TB cases treated in public clinics. A subset of HIV-infected TB patients identified through this system had additional data collected for a research study. We conducted multivariate analysis to identify factors associated with MDR-TB. Of 10,428 TB patients, 2,376 (23%) were HIV-infected; 145 (1%) had MDR-TB. Of the MDR-TB cases, 52 (37%) were HIV-infected. Independent risk factors for MDR-TB included age 18-29 years old, male sex, and previous TB treatment, but not HIV infection. Among new patients, having an injection drug use history was a risk factor for MDR-TB. Of 539 HIV-infected TB patients in the research study, MDR-TB was diagnosed in 19 (4%); the only significant risk factors were previous TB treatment and previous hepatitis. In Thailand, HIV is common among MDR-TB patients, but is not an independent risk factor for MDR-TB. Populations at high risk for HIV-young adults, men, injection drug users - should be prioritized for drug susceptibility testing.
Akksilp
Somsak
S
Office of Disease Prevention and Control 7, Ubon Ratchathani, US Centers for Disease Control and Prevention Collaboration, Nonthaburi.
Wattanaamornkiat
Wanpen
W
Kittikraisak
Wanitchaya
W
Nateniyom
Sriprapa
S
Rienthong
Somsak
S
Sirinak
Chawin
C
Ngamlert
Keerataya
K
Mankatittham
Wiroj
W
Sattayawuthipong
Wanchai
W
Sumnapun
Surin
S
Yamada
Norio
N
Monkongdee
Patama
P
Anuwatnonthakate
Amornrat
A
Burapat
Channawong
C
Wells
Charles D
CD
Tappero
Jordan W
JW
Varma
Jay K
JK
D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D018571:Sentinel Surveillance; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000453:epidemiology