Is Multi-Drug Resistant Tuberculosis More Prevalent in HIV-Infected Patients in Korea?

Abstract

The epidemiological synergy between human immunodeficiency virus (HIV) and tuberculosis (TB) is a major threat to public health. However, the association between HIV and multi-drug resistant tuberculosis (MDR-TB) is not clear. To explore the association between HIV and MDR-TB infection, a case-control study was performed in Korea. A total of 1606 culture-proven TB patients (45 HIV vs. 1561 non-HIV) from January 2006 to October 2014 were included in this analysis. MDR-TB rates were 11.1% and 8.2% in the HIV and non-HIV groups, respectively (p=0.42), thus indicating that MDR-TB was not significantly associated with HIV infection in Korea.

Prevalence of Multidrug-Resistant Tuberculosis in HIV/Tuberculosis Co-Infected Patients

“…Among HIV-infected patients, those with multidrug-resistant (MDR)-TB are more likely to die and less likely to be cured or undergo complete treatment compared to those with non-MDR-TB [ 4 ]. The prevalence of MDR-TB varied from 11.1% to 32.7% in HIV/TB co-infected patients in the Korea [ 5 6 ]. However, limited data are available on MDR-TB in HIV/TB co-infected patients, with the estimated prevalence of MDR-TB in this patient population varying considerably across studies.…”

“…Furthermore, the prevalence of MDR-TB in HIV/TB co-infected patients is higher than that in the general population in the Korea (approximately 3 - 6%) [ 8 9 ]. Studies have reported varying results regarding the prevalence of MDR-TB among HIV/TB co-infected cases [ 5 6 ]. One study reported that this prevalence was 32.7% (18/55) and that the median CD4 cell count at TB diagnosis was lower in the MDR-TB group than in the non-MDR-TB group (57 cells/mm 3 vs. 121 cells/mm 3 ) [ 6 ].…”

“…One study reported that this prevalence was 32.7% (18/55) and that the median CD4 cell count at TB diagnosis was lower in the MDR-TB group than in the non-MDR-TB group (57 cells/mm 3 vs. 121 cells/mm 3 ) [ 6 ]. Another study reported that the prevalence of MDR-TB in the HIV group (11.1% [5/45]) and was not significantly different from that in the non-HIV group (8.2% [128/1,561]) [ 5 ]. Because the second study did not report the CD4 cell count, a clear comparison of the patient characteristics between the above two studies is not possible.…”

Characteristics of TB/HIV Co-Infection and Patterns of Multidrug-Resistance Tuberculosis in the Northwest Amhara, Ethiopia

“…45 It is, therefore, mostly the TB patients with HIV-positive cases are could be true that increase the risk of developing MDR-TB by dropping the immune response due to their immunocompromised state. However, other investigators did not find any significant association of HIV co-infection with MDR-TB from central Ethiopia, 46 Korea, 47 and Mali. 48 Significantly, TB patients who had previously treated cases were six times more likely to develop MDR-TB (aOR = 6.73, 95% CI: 1.78–25.47, p = 0.005).…”

Identification of Missing Carbon Fixation Enzymes as Potential Drug Targets in Mycobacterium Tuberculosis

“…As per World Health Organization (WHO) records in 2015, the estimated number of TB cases was 10.4 million, followed by 1.8 million TB related deaths annually (http://www.who.int/gho/tb/en/). Though the rate of new TB cases has shrunk, the synergistic relationship between drug resistance TB [multi drug-resistant (MDR); extensively drug-resistant (XDR)] and HIV (TB/HIV coinfection) has transformed TB into a serious public health threat [1], [2], [3]. As an intracellular pathogen, Mtb is exposed to a strong host response, including low pH (H+), hydrogen peroxide (H 2 O 2 ), hypochlorous acid (HOCl) and toxic gasses such as nitric oxide (NO), carbon monoxide (CO), and superoxide during the infection [4].…”