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Tuberculosis (TB) is the most common opportunistic infection in human immunodeficiency virus (HIV)-infected patients and the emergence of drug-resistant tuberculosis (DR-TB) is a growing problem in resource-limited settings. Adequate infrastructure for testing drug sensitivity and sufficient evidence of first-line resistance are currently unavailable in Nigeria. We collected sputum samples from HIV-infected patients enrolled in the Harvard PEPFAR/APIN Plus program over 12 months at two PEPFAR antiretroviral therapy (ART) clinics in the southwest and north central regions in Nigeria. Smear-positive sputum samples were submitted for GenoType MTBDRplus testing (n = 415); mutations were confirmed through sequencing. Our results show high rates of DR-TB in Nigerian HIV-infected individuals (7.0% for rifampin [RIF] and 9.3% for RIF or isoniazid [INH]). Total RIF resistance indicative of MDR-TB in treatment-naive patients was 5.52%, far exceeding the World Health Organization predictions (0 to 4.3%). RIF resistance was found in 6/213 (2.8%) cases, INH resistance was found in 3/215 (1.4%) cases, and MDR-TB was found in 8/223 (3.6%) cases. We found significantly different amounts of DR-TB by location (18.18% in the south of the country versus 3.91% in the north central region [P < 0.01]). Furthermore, RIF resistance was genetically distinct, suggesting possible location-specific strains are responsible for the transmission of drug resistance (P < 0.04). Finally, GenoType MTBDRplus correctly identified the drug-resistant samples compared to sequencing in 96.8% of cases. We found that total DR-TB in HIV-infection is high and that transmission of drug-resistant TB in HIV-infected patients in Nigeria is higher than predicted.

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Autor(es)

Dinic, L -  Akande, P. -  Idigbe, E. O. -  Ani, A. -  Onwujekwe, D. -  Agbaji, O. -  Akanbi, M. -  Nwosu, R. -  Adeniyi, B. -  Wahab, M. -  Lekuk, C. -  Kunle -  Ope, C. -  Nwokoye, N. -  Kanki, Phyllis Jean - 

Id.: 65357358

Idioma: inglés (Estados Unidos)  - 

Versión: 1.0

Estado: Final

Tipo de recurso: Journal Article  - 

Tipo de Interactividad: Expositivo

Nivel de Interactividad: muy bajo

Audiencia: Estudiante  -  Profesor  -  Autor  - 

Estructura: Atomic

Coste: no

Copyright: sí

: open

Requerimientos técnicos:  Browser: Any - 

Relación: [References] doi:10.1128/JCM.00982-12
[References] Journal of Clinical Microbiology

Fecha de contribución: 29-ago-2017

Contacto:

Localización:
* Dinic, L., P. Akande, E. O. Idigbe, A. Ani, D. Onwujekwe, O. Agbaji, M. Akanbi, et al. 2012. “Genetic Determinants of Drug-Resistant Tuberculosis Among HIV-Infected Patients in Nigeria.” Journal of Clinical Microbiology 50 (9) (June 27): 2905–2909. doi:10.1128/jcm.00982-12.
* 0095-1137

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