Impact of HIV Infection on the Recurrence of Tuberculosis in South India

Narayanan, Sujatha and Swaminathan, Soumya and Supply, Philip and Shanmugam, Sivakumar and Narendran, G and Hari, Lalitha and Ramachandran, Ranjani and Locht, C and Jawahar, M S and Narayanan, P R (2010) Impact of HIV Infection on the Recurrence of Tuberculosis in South India. Journal of Infectious Diseases, 201 (5). pp. 691-703. ISSN Print: 0022-1899 | Electronic: 1537-6613

Archive 201016.pdf - Published Version Download (3MB)

Abstract

Background. There is limited information on the relative proportion of reactivation and reinfection at the time of recurrence among human immunodeficiency virus (HIV)-infected and HIV-uninfected patients who are successfully treated for tuberculosis infection in India. Methods. HIV-infected and HIV-uninfected patients with sputum culture-positive pulmonary tuberculosis were treated with short-course regimens and followed up for 36 months at the Tuberculosis Research Centre, South India. Bacteriologic recurrences were documented, and typing of strains was performed using 3 different genotypic techniques: restriction fragment length polymorphism (RFLP) by IS6110, spoligotyping, and mycobacterial interspersed repeat unit (MIRU)-variable number tandem repeat (VNTR). DNA fingerprints of paired Mycobacterium tuberculosis isolates (baseline and recurrence) were compared. Results. Among 44 HIV-infected and 30 HIV-uninfected patients with recurrent tuberculosis during the period July 1999 to October 2005, 25 and 23 paired isolates, respectively, were typed using all 3 methods. Recurrence was due to exogenous reinfection in 88% of HIV-infected and 9% of HIV-uninfected patients (P < .05). Among recurrent isolates, the HIV-infected patients showed more clustering, as well as a higher proportion of drug resistance, including multidrug resistance. Conclusions. In India, a tuberculosis-endemic country, most recurrences after successful treatment of tuberculosis are due to exogenous reinfection in HIV-infected persons and endogenous reactivation in HIV-uninfected persons. Strategies for prevention and treatment of tuberculosis infection must take these findings into consideration.

Affiliation:	National Institute for Research in Tuberculosis
Item Type:	Article
Uncontrolled Keywords:	HIV, Infection, Tuberculosis, South India
Subjects:	Tuberculosis > Laboratory Research > Immunological
Divisions:	Basic Science Research > Immunology
Depositing User:	Dr. Rathinasabapati R
Date Deposited:	18 Mar 2022 11:12
Last Modified:	18 Mar 2022 11:12
URI:	http://eprints.nirt.res.in/id/eprint/1032

Actions (login required)

View Item