title: Tuberculosis relapse in Vietnam is significantly associated with Mycobacterium tuberculosis Beijing genotype infections.
abstract: BACKGROUND
  In Vietnam, the Mycobacterium tuberculosis Beijing genotype is associated with multi-drug resistance and is emerging. A possible explanation for this genotype's success is an increased rate of relapse.
  
  
  METHODS
  In a prospective cohort study, isolates from patients with smear-positive tuberculosis were subjected to drug susceptibility testing and to spoligotyping and variable number of tandem repeats typing before treatment and after recurrence of tuberculosis.
  
  
  RESULTS
  Among 1068 patients who were actively followed up over 18 months for recurrence, 23 relapse cases occurred (1.39 cases/100 person-years). After adjustment for genotype, tuberculosis treatment history, and drug resistance, relapse was significantly associated with the Beijing genotype (adjusted hazard ratio [aHR], 5.48; 95% confidence interval [CI], 2.06-14.55) and isoniazid resistance (aHR, 5.91; 95% CI, 2.16-16.16).
  
  
  CONCLUSIONS
  The strongly increased relapse rate in tuberculosis cases caused by Beijing strains probably contributes to the successful spread of this genotype in Vietnam and elsewhere.
authors: Pham Ngoc Thach Hospital, Ho Chi Minh, Vietnam.
authors: Mai N T
authors: MN
authors: Huyen
authors: Tran N
authors: TN
authors: Buu
authors: Edine
authors: E
authors: Tiemersma
authors: Nguyen T N
authors: NT
authors: Lan
authors: Nguyen H
authors: NH
authors: Dung
authors: Kristin
authors: K
authors: Kremer
authors: Dick V
authors: DV
authors: Soolingen
authors: Frank G J
authors: FG
authors: Cobelens
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D015331:Cohort Studies; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity*; D009525:Niacin / Q000627:therapeutic use; D015995:Prevalence; D011446:Prospective Studies; D012008:Recurrence; D012293:Rifampin / Q000627:therapeutic use; D012424:Rural Population; D013307:Streptomycin / Q000627:therapeutic use; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D014744:Vietnam / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents; D009525:Niacin; D012293:Rifampin; D013307:Streptomycin