Portal de Periódicos da CAPES

Primary drug resistance in HIV/tuberculosis patients in two large cities of Siberia

2016; Elsevier BV; Linguagem: Inglês

10.1183/13993003.congress-2016.pa2765

1873-281X

Arkadiy Khanin, И. Б. Викторова, О. Н. Конончук,

Pneumocystis jirovecii pneumonia detection and treatment

The aim of the study was to examine the spectrum of primary drug resistance in HIV-positive patients with tuberculosis (HIV/TB) in the two major cities of Kemerovo region (Russia). Materials and methods: retrospective study of all new HIV/TB cases (n=294) registered in 2013 in these two cities of Kemerovo region (Kemerovo, pop. 536000 and Novokuznetsk, pop. 549000). Regional HIV prevalence in 2013 was 1096,5/100 000, TB incidence – 101,5/100 000. 106 new cases were registered in 2013 in Kemerovo and 188 cases in Novokuznetsk. The mean age was 34,1 years; median CD 4 count was 215 cells/μl. Culture positive were 65,1% (n=69) in Kemerovo and 61,7% (n=116) in Novokuznetsk. Drug susceptibility test was conducted on Löwenstein-Jensen media using absolute concentration method in 65 Kemerovo and 108 Novokuznetsk culture positive cases. Results: Primary multidrug resistance was detected in 53,8% cases (n=17) in Kemerovo (including 2 cases of XDR, 3,1%) and in 56,5% (n=61) in Novokuznetsk (including 1 XDR case, 0,9%). Other types of resistance were observed in 20% (n=13) in Kemerovo, and in 14,8 % (n=16) in Novokuznetsk. It should be noted that MDR was recorded in 61,5% of patients with CD 4 <200 cells/μl (16 out of 26) in Kemerovo and in 53,1% (26 out of 49) in Novokuznetsk; the level of MDR in patients with CD 4 >200 cells/μl was 50% in Kemerovo (16 out of 32) and 58,1% in Novokuznetsk (25 out of 43) (p>0,05). Conclusion: in the two cities of the region with high burden of both TB and HIV-infection, MDR was determined in more than 50% of new HIV/TB patients. The frequency of MDR didn9t depend on the degree of immunosuppression.