High prevalence of drug resistance amongst HIV-exposed and -infected children in a tuberculosis prevention trial

Date
2012
Authors
Hesseling A.C.
Kim S.
Madhi S.
Nachman S.
Schaaf H.S.
Violari A.
Victor T.C.
McSherry G.
Mitchell C.
Cotton M.F.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
An emergence of drug-resistant tuberculosis (DR-TB) in settings affected by human immunodeficiency virus (HIV) and tuberculosis (TB) has been observed. We investigated the prevalence of DR-TB in P1041, a multicentred, randomised, double-blind trial which compared the administration of isoniazid (INH) to placebo, in HIV-exposed, non-infected and -infected African infants in the absence of any documented TB exposure. The prevalence of multidrug-resistant TB (MDR-TB) was 22.2% (95%CI 8.5-45.8) and INH monoresistance 5.6% (95%CI 0.1-27.6) among culture-confirmed cases, with all MDR-TB occurring in a single site. There was no association between INH treatment or placebo group, or between HIV infection status, and DR-TB prevalence. There was a high prevalence of DR-TB among HIV-exposed and -infected children. Surveillance of DR-TB among children in high-burden TB-HIV settings should be routine. © 2012 The Union.
Description
Keywords
ethambutol, ethionamide, isoniazid, ofloxacin, placebo, pyrazinamide, rifampicin, antibiotic sensitivity, article, child, clinical article, controlled study, double blind procedure, drug resistant tuberculosis, female, genotype, human, Human immunodeficiency virus infection, infant, inhA gene, katG gene, male, marker gene, multicenter study, multidrug resistant tuberculosis, Negro, preschool child, prevalence, priority journal, randomized controlled trial, rpoB gene, South Africa, tuberculosis
Citation
International Journal of Tuberculosis and Lung Disease
16
2
192
195