High prevalence of drug resistance amongst HIV-exposed and -infected children in a tuberculosis prevention trial [Short communication]
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.
Document Type: Research Article
Affiliations: 1: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, South Africa 2: Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Massachusetts, USA 3: Medical Research Council: Respiratory and Meningeal Pathogens Research Unit & Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa 4: Department of Pediatrics, State University of New York, Stony Brook, New York, USA 5: Perinatal HIV Research Unit, Chris Hani Baragwanath Hospital, Johannesburg, South Africa 6: Department of Science and Technology/National Research Foundation Centre of Excellence in Biomedical Tuberculosis Research/Medical Research Council Centre for Molecular and Cellular Biology, Department of Medical Biochemistry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa 7: Penn State College of Medicine, Hershey, Pennsylvania, USA 8: University of Miami Miller School of Medicine, Miami, Florida, USA 9: KidCru, Tygerberg Academic Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa
Publication date: February 1, 2012
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