High prevalence of drug-resistant tuberculosis and other mycobacteria among HIV-infected patients in Brazil: a systematic review
Bammann, R.H.; Zamarioli, L.A.; Pinto, V.S.; Vázquez, C.M.P.; Litvoc, M.N.; Klautau, G.B.; Melo, F.A.F.úz.d.; Cavalcante, N.J.; Ferrazoli, L.
Memorias do Instituto Oswaldo Cruz 105(6): 838-841
2010
ISSN/ISBN: 0074-0276 PMID: 20945003 DOI: 10.1590/s0074-02762010000600019Document Number: 625382
There is a little-noticed trend involving human immunodeficiency virus (HIV)-infected patients suspected of having tuberculosis: the triple-treatment regimen recommended in Brazil for years has been potentially ineffective in over 30% of the cases. This proportion may be attributable to drug resistance (to at least 1 drug) and/or to infection with non-tuberculous mycobacteria. This evidence was not disclosed in official statistics, but arose from a systematic review of a few regional studies in which the diagnosis was reliably confirmed by mycobacterial culture. This paper clarifies that there has long been ample evidence for the potential benefits of a four-drug regimen for co-infected patients in Brazil and it reinforces the need for determining the species and drug susceptibility in all positive cultures from HIV-positive patients.