Multidrug-resistant TB and HIV in Thailand: overlapping, but not independently associated, risk factors. -
Multidrug-resistant TB and HIV in Thailand: overlapping, but not independently associated, risk factors.
Southeast Asian J Trop Med Public Health. 2009 Sep;40(5):1000-14
Authors: Akksilp S, Wattanaamornkiat W, Kittikraisak W, Nateniyom S, Rienthong S, Sirinak C, Ngamlert K, Mankatittham W, Sattayawuthipong W, Sumnapun S, Yamada N, Monkongdee P, Anuwatnonthakate A, Burapat C, Wells CD, Tappero JW, Varma JK
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.
PMID: 19842383 [PubMed - in process] [Tuberculous Meningitis]