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

Authors: Hesseling, A. C.1; Kim, S.2; Madhi, S.3; Nachman, S.4; Schaaf, H. S.1; Violari, A.5; Victor, T. C.6; McSherry, G.7; Mitchell, C.8; Cotton, M. F.9; IMPAACT P1041 Team

Source: The International Journal of Tuberculosis and Lung Disease, Volume 16, Number 2, 1 February 2012 , pp. 192-195(4)

Publisher: International Union Against Tuberculosis and Lung Disease

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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.

Keywords: HIV; children; isoniazid prevention; resistance; tuberculosis

Document Type: Research Article

DOI: http://dx.doi.org/10.5588/ijtld.10.0795

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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  • 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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