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Free Content Human immunodeficiency virus-related tuberculosis and primary drug resistance in Bangkok, Thailand

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SETTING: Central Chest Hospital, a 500-bed referral hospital near Bangkok with a large out-patient department.

OBJECTIVES: To determine human immunodeficiency virus (HIV) seroprevalence among patients with pulmonary tuberculosis (TB), and compare HIV-positive and HIV-negative TB patients.

DESIGN: From July 1995 through June 1996, a cross-sectional study was conducted of newly registered adults (≥16 years old) with suspected pulmonary TB.

RESULTS: Of 2587 newly registered patients with suspected pulmonary TB, 2019 (78%) received HIV pretest counseling and 1816 (90%) consented to testing. Of these, 364 (20%) were HIV-seropositive. Among 1091 patients with bacteriologically confirmed TB, HIV seroprevalence was 22%. HIV-positive patients were more likely to be young, unemployed, single men and to have a history of injection drug use. HIV-positive patients with first-episode TB were more likely to have Mycobacterium tuberculosis strains resistant to isoniazid (10.9% vs 3.5%; P < 0.001), rifampicin (9.4% vs 2.9%; P < 0.001), and at least isoniazid and rifampicin (multidrug-resistant TB [MDR-TB]; 5.2% vs 0.4%; P < 0.001).

CONCLUSIONS: HIV prevalence is high among TB patients at this Bangkok hospital and is associated with drug resistance, including a 12 times higher risk of MDR-TB. These findings underscore the urgent need to assure adherence to complete, effective TB treatment regimens for all patients, including persons who are potentially difficult to manage such as injection drug users.
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Keywords: Asia; HIV; Thailand; drug resistance; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Central Chest Hospital, Department of Communicable Disease Control, Ministry of Public Health, Nonthaburi, Thailand 2: The HIV/AIDS Collaboration, Nonthaburi, Thailand; and Division of HIV/AIDS Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 3: The HIV/AIDS Collaboration, Nonthaburi, Thailand

Publication date: 2000-06-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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