Human immunodeficiency virus and tuberculosis in Argentina: prevalence, genotypes and risk factors

Abstract

The objective of this study was to determine the prevalence and genetic variability of human immunodeficiency virus type 1 (HIV-1) and other sexually transmitted infections (STIs) among 205 patients with clinical diagnosis of tuberculosis (TB) in Buenos Aires in 2001. Infections with hepatitis B virus (HBV), HIV-1, hepatitis C virus (HCV), Treponema pallidum and human T-cell lymphotropic virus types I/II were diagnosed in 37/187 (19.8 %), 35/205 (17.1 %), 22/187 (11.8 %), 13/187 (7.0 %) and 4/181 (2.2 %) patients, respectively. Almost one in three participants (33.1 %) presented at least one infection in addition to TB. Multiresistance to TB drugs (isoniazid plus rifampicin) was detected in the isolates recovered from three patients. Injecting drug use was detected as the main risk factor for HIV, HBV and HCV infections. Of ten patients who died, eight were infected with HIV. HIV genetic characterization showed the presence of two different subtypes. Env subtype F was found in 13/24 samples (54.2 %) and subtype B in 11/24 samples (45.8 %) by heteroduplex mobility assay. Sequencing of the protease/RT region was performed in ten samples: three were characterized as subtype B and seven as B/F recombinants by bootscanning analysis. Phylogenetic analysis of four full-length Abbreviations: AIDS, acquired immunodeficiency syndrome; HMA, heteroduplex mobility assay; IDU, intravenous drug user; OR, odds ratio; RT, reverse transcriptase; STI, sexually transmitted infection; TB, tuberculosis. sequences showed that three were the circulating recombinant form CRF12_BF. The results of this study suggest an urgent need to detect HIV infection in high-risk groups to prevent future HIV transmission as well as morbidity and mortality associated with TB by providing highly active antiretroviral therapy (HAART) and/or TB treatment. Collaboration between TB and HIV programmes seems to be the best approach to decrease the incidence of these diseases, especially in high-prevalence HIV settings.

Prevalence of hepatitis B virus infection among tuberculosis patients with or without HIV in Goiânia City, Brazil

“…23,24 The prevalence determined in this study was within the confidence interval range reported for injecting drug users (27.1%; 95% CI: 23.6-30.8) and hemodialysis patients (29.8%; 95% CI: 27.1-32.5). 25,26 Relative to other data reported in TB patients, the HBV prevalence determined in this study was similar to prevalence rates observed in Rio de Janeiro, Brazil (26.8%; 95% CI: 19.7-31.9) and Argentina (19.8%; 95% CI: 14.3-26.2), 12,13 but was higher than rates determined in Georgia (13%; 95% CI: 9.5-17.5) and Taiwan (11.7%; 95% CI: 6.8-15.5). 9,11 The high prevalence rates of HBV infection found in TB/HIVinfected patients and in patients with TB only were similar to those observed in Rio de Janeiro (35.8% and 14.6%, respectively).…”

“…In fact, injecting drug use was an independent risk factor for HBV infection in the study population described in this report. This behavior has been reported by others among TB patients, 9,13 reflecting the high transmissibility of HBV through direct blood contact resulting from the sharing of syringes and needles. In addition, non-injecting drug use was statistically associated with HBV infection in the study population described here, which was probably linked to percutaneous exposures related to sharing of non-injection drug implements such as pipes and straws for smoking and sniffing/snorting, which could lead to blood-to-blood contact.…”

“…13 Age may be a proxy for lifetime exposure, indicating that, over time, there is a cumulative risk of HBV infection linked to sexual and percutaneous exposures. In fact, injecting drug use was an independent risk factor for HBV infection in the study population described in this report.…”

Predominance of Human Lymphotropic T Cell Virus Type 2 Subtype b in Urban Populations of Argentina

“…48,49 After a personal interview with healthcare staff, patients were invited to sign an informed consent. The institutional review board and the scientific ethical committee at the University of Buenos Aires approved the study protocols.…”

“…Enrollment and data collection procedure details have been previously described. 48,49 Serology and molecular diagnosis for HTLV-1/2 Antibody screening for HTLV-1/2 was performed by a particle agglutination technique (SERODIA-HTLV-I, FUJIR-EBIO, Tokyo, Japan) and reactive samples were subjected to Western blot confirmation (HTLV blot 2.4, Genelabs Diagnostics, Science Park, Singapore). According to the manufacturer's criteria, HTLV-2-positive samples showed reactivity to p19 or p24, GD21, and rgp46-II.…”