Primary drug resistance in HIV/tuberculosis patients in two large cities of Siberia

Abstract

The aim of the study was to examine the spectrum of primary drug resistance in HIV-positive patients with tuberculosis (HIV/TB) in the two major cities of Kemerovo region (Russia). Materials and methods: retrospective study of all new HIV/TB cases (n=294) registered in 2013 in these two cities of Kemerovo region (Kemerovo, pop. 536000 and Novokuznetsk, pop. 549000). Regional HIV prevalence in 2013 was 1096,5/100 000, TB incidence – 101,5/100 000. 106 new cases were registered in 2013 in Kemerovo and 188 cases in Novokuznetsk. The mean age was 34,1 years; median CD 4 count was 215 cells/μl. Culture positive were 65,1% (n=69) in Kemerovo and 61,7% (n=116) in Novokuznetsk. Drug susceptibility test was conducted on Lowenstein-Jensen media using absolute concentration method in 65 Kemerovo and 108 Novokuznetsk culture positive cases. Results: Primary multidrug resistance was detected in 53,8% cases (n=17) in Kemerovo (including 2 cases of XDR, 3,1%) and in 56,5% (n=61) in Novokuznetsk (including 1 XDR case, 0,9%). Other types of resistance were observed in 20% (n=13) in Kemerovo, and in 14,8 % (n=16) in Novokuznetsk. It should be noted that MDR was recorded in 61,5% of patients with CD 4 4 >200 cells/μl was 50% in Kemerovo (16 out of 32) and 58,1% in Novokuznetsk (25 out of 43) (p>0,05). Conclusion: in the two cities of the region with high burden of both TB and HIV-infection, MDR was determined in more than 50% of new HIV/TB patients. The frequency of MDR didn9t depend on the degree of immunosuppression.