HIV infection and primary resistance to antituberculosis drugs in Abidjan, Côte dʼIvoire

Abstract

Objective To determine the prevalence of Mycobacterium tuberculosis resistance to antituberculosis drugs, and to relate this resistance to HIV serologic status. Design Cross-sectional prevalence study. Setting The two major outpatient tuberculosis clinics in Abidjan, Côte d'Ivoire, West Africa. Patients Sixty individuals with newly diagnosed pulmonary tuberculosis and sputum smears positive for acid-fast bacilli. Main outcome measures HIV serologic status and in vitro testing for susceptibility of M. tuberculosis isolates to antituberculosis drugs. Results M. tuberculosis was isolated from 82% (49 out of 60) of sputum specimens. Thirty-five per cent (17 out of 49) were obtained from HIV-seropositive and 65% (32 out of 49) from HIV-seronegative patients. There was no statistically significant difference in the proportion of resistant isolates from HIV-seropositive versus HIV-seronegative patients, although the relatively small sample size limited power. Of the total number of isolates, 17% were resistant to isoniazid; resistance was less to streptomycin (7%), rifampin (2%), pyrazinamide (0%), and ethambutol (0%). Eighteen and 21% of mycobacterial isolates from HIV-seropositive and HIV-seronegative individuals, respectively, were resistant to one or more of these drugs. Conclusions Surveys of this type are useful in planning and evaluating tuberculosis preventive therapy in individuals with dual infection.