Pablo E. Campos,*† Pedro G. Suarez,‡ Jorge Sanchez,†§ David Zavala,‡ Jorge Arevalo,‡ Eduardo Ticona,‡ Charles M. Nolan,*¶ Thomas M. Hooton,* and King K. Holmes*
Emerg Infect Dis 2003 Dec;9(12):1571-78
During 1999 to 2000, we identified HIV-infected persons with new episodes of tuberculosis (TB) at 10 hospitals in Lima-Peru and a random sample of other Lima residents with TB. Multidrug-resistant (MDR)-TB was documented in 35 (43%) of 81 HIV-positive patients and 38 (3.9%) of 965 patients who were HIV-negative or of unknown HIV status (p < 0.001). HIV-positive patients with MDR-TB were concentrated at three hospitals that treat the greatest numbers of HIV-infected persons with TB. Of patients with TB, those with HIV infection differed from those without known HIV infection in having more frequent prior exposure to clinical services and more frequent previous TB therapy or prophylaxis. However, MDR-TB in HIV-infected patients was not associated with previous TB therapy or prophylaxis. MDR-TB is an ongoing problem in HIV-infected persons receiving care in public hospitals in Lima and Callao; they represent sentinel cases for a potentially larger epidemic of nosocomial MDR-TB.
Initial multidrug-resistant (MDR) tuberculosis (TB) in HIV-negative patients treated at a Buenos Aires referral hospital from 1991 to 2000 was examined by using molecular clustering of available isolates. Of 291 HIV-negative MDRTB patients, 79 were initially MDR. We observed an ascending trend of initial MDRTB during this decade (p=0.0033). The M strain, which was responsible for an institutional AIDS-associated outbreak that peaked in 1995 to 1997, caused 24 of the 49 initial MDRTB cases available for restriction fragment length polymorphism.
Kalyanee Torugsa,* Scott Anderson,† Nucharee Thongsen,* Narongrid Sirisopana,* Achara Jugsudee,‡ Pitak Junlananto,‡ Sorachai Nitayaphan,* Suebpong Sangkharomya,* and Arthur E. Brown*
Emerg Infect Dis 2003 Jul;9(7):881-83
Characterization of the HIV epidemic in Thailand has benefited from the systematic testing of young men upon entry into the military. These data, which have shown that public health measures can reverse an HIV epidemic, have been reanalyzed with current geographic information systems methods. The resulting maps, thus far, are the best means of visualizing the geography of the dynamic HIV epidemic in Thailand.
Multidrug-resistant Mycobacterium tuberculosis in HIV-Infected Persons, Peru
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