HIV Infection and Primary Resistance to Antituberculosis Drugs in Abidjan, Côte D'Ivoire

Objective: To determine the prevalence of Mycobacterium tuberculosis resistance to antituberculosis drugs, and to relate this resistance to HIV serologic status.

Design: Cross-sectional prevalence study.

Setting: The two major outpatient tuberculosis clinics in Abidjan, Côte d'Ivoire, West Africa.

Patients: Sixty individuals with newly diagnosed pulmonary tuberculosis and sputum smears positive for acid-fast bacilli.

Main Outcome Measures: HIV serologic status and in vitro testing for susceptibility of M. tuberculosis isolates to antituberculosis drugs.

Results: M. tuberculosis was isolated from 82% (49 out of 60) of sputum specimens. Thirty-five per cent (17 out of 49) were obtained from HIV-seropositive and 65% (32 out of 49) from HIV-seronegative patients. There was no statistically significant difference in the proportion of resistant isolates from HIV-seropositive versus HIV-seronegative patients, although the relatively small sample size limited power. Of the total number of isolates, 17% were resistant to isoniazid; resistance was less to streptomycin (7%), rifampin (2%), pyrazinamide (0%), and ethambutol (0%). Eighteen and 21% of mycobacterial isolates from HIV-seropositive and HIV-seronegative individuals, respectively, were resistant to one or more of these drugs.

Conclusions: Surveys of this type are useful in planning and evaluating tuberculosis preventive therapy in individuals with dual infection.