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Document 0582
DOCN M9640582
TI Mycobacterial infection in HIV seropositive and seronegative
populations, 1987-93.
DT 9604
AU Taylor IK; Evans DJ; Coker RJ; Mitchell DM; Shaw RJ; Department of
Respiratory Medicine, St Mary's Hospital Medical; School, London, UK.
SO Thorax. 1995 Nov;50(11):1147-50. Unique Identifier : AIDSLINE
MED/96149317
AB BACKGROUND--Although the causes of the worldwide resurgence of
tuberculosis are multifactorial, the HIV epidemic is believed to have
had a central role. Control is further threatened by the emergence of
multidrug-resistant tuberculosis. METHODS--A retrospective evaluation
was undertaken of trends in pulmonary and extrapulmonary culture
positive mycobacterial pathology, and the prevalence of drug-resistant
tuberculosis in both HIV seropositive and, presumptively, HIV
seronegative patients receiving their clinical care at St Mary's
Hospital, London. Five hundred and thirty eight patients (188 of whom
were known to be HIV seropositive) with positive mycobacterial isolates
between January 1987 and March 1993 were identified from laboratory
records. These were cross referenced with drug surveillance records.
RESULTS--Overall, between 1987 and 1992 there was a progressive 3.5 fold
increase in positive mycobacterial isolates and a 2.5 fold increase in
patients with proven mycobacterial infection. This increase was greater
within the HIV seropositive population. A total of 663 positive
mycobacterial isolates was evaluated; the major pathogen identified was
Mycobacterium tuberculosis (379 isolates, 57%). Three hundred and
fourteen patients were diagnosed as having M tuberculosis, 49 of whom
were HIV seropositive. M tuberculosis was predominantly isolated from
the lung. Of 358 positive cultures for M tuberculosis (68 HIV
seropositive, 290 presumptively HIV seronegative), only 27 isolates
(7.6%), almost exclusively derived from presumed HIV seronegative
patients, were resistant to either isoniazid, rifampicin, or both drugs
together. No increases in drug-resistant isolates were observed over
this period. CONCLUSIONS--There has been a considerable increase in the
incidence of tuberculosis in both HIV seronegative and seropositive
populations during the study period. The emergence of drug-resistant
tuberculosis was not observed.
DE Adolescence Adult Aged Aged, 80 and over Child Child, Preschool
Female Human *HIV Seronegativity HIV
Seropositivity/*COMPLICATIONS/MICROBIOLOGY Male Middle Age
Mycobacterium/ISOLATION & PURIF Mycobacterium
Infections/*COMPLICATIONS/EPIDEMIOLOGY/IMMUNOLOGY Prevalence
Retrospective Studies Tuberculosis/COMPLICATIONS Tuberculosis,
Multidrug-Resistant/COMPLICATIONS JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).