Tuberculosis and HIV: Renewed Challenge

Abstract

HIV infection is responsible for an increased incidence of pulmonary tuberculosis (TB) in several areas of the world (MC Raviglione et al. 1995 JAMA 276: 220-226). In general, active TB happens as a consequence of a recently acquired exogenous infection of Mycobacterium tuberculosis or of endogenous reactivation of old infection. In some regions, besides the increase of the incidence, an important change in the dynamics of the transmission of M. tuberculosis took place. This change was more evident in closed places (hospitals, prisons, housings) where the prevalence of inmates infected by HIV is high (D

Perfil e seguimento dos pacientes portadores de Mycobacterium sp. do Hospital das Clínicas da Universidade Federal de Minas Gerais

“…(8) É também necessária a implantação de novas técnicas efetivas e rápidas para o diagnóstico da tuberculose. (11,12) Recebemos no HC/UFMG principalmente pacientes procedentes de Belo Horizonte e região metropolitana. Uma grande percentagem de pacientes era proveniente do pronto-atendimento (21%) e enfermarias (20%).…”

“…do Hospital das Clínicas da Universidade Federal de Minas Gerais dados da literatura. (11)(12)(13) Observamos que a taxa de positividade para o HIV encontrada em pacientes com tuberculose atendidos no hospital foi muito superior àquela referida nos atendidos nas unidades primárias de saúde. Além disso, a maioria dos óbitos ocorreu em pacientes HIV positivos.…”

Mutations in the rpoB gene of rifampicin-resistant Mycobacterium tuberculosis strains isolated in Brazil and France

“…Since 1981, the Brazilian National Tuberculosis Control Program adopted the daily selfadministered short-course treatment regimen (2 RMP + INH + PZA/4 RMP + INH). The urban areas have reached 28% leading to an increase of tuberculosis abandon (Kritski et al , 1998. In Rio de Janeiro, drug-resistance surveillance performed in outpatient clinic showed a level of 1% of RMP primary resistance, but in patients attended in hospital, it increases to 7% (Pablo-Mendez et al 1998).…”

Predictive value of the acid fast smear for detection of Mycobacterium tuberculosis in respiratory specimens in a Reference Center of HIV/Aids in Rio de Janeiro, Brazil

“…Since NTM are indistinguishable from M.tb in AFB smear, the value of positive AFB in respiratory specimens for predicting pulmonary TB is unclear, especially where the prevalence of NTM is unknown. In Rio de Janeiro, Brazil, the prevalence of co-infection of HIV and disseminated mycobacterial disease is expected to be high (Grinsztejn et al 1997, Kritski et al 1998. We therefore conducted a study in a General Hospital in Rio de Janeiro with a high prevalence of HIV and mycobacterial infections.…”