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Implications of HIV infection on standard chemotherapy of tuberculosis in Kabarole District, western Uganda.
Sunderson P; Abesigamukama H; Tinkasimire G; Kipp W; Rehle T; German
November 30, 1993
Int Conf AIDS. 1993 Jun 6-11;9(1):321 (abstract no. PO-B07-1115). Unique

The purpose of this study was to examine the impact of the HIV infection on patients with smear positive tuberculosis in Kabarole district, receiving standard chemotherapy with streptomycin and thiacetazone tablets. All newly diagnosed patients in Fort Portal Hospital with three positive sputum examinations for Mycobacterium tuberculosis were enrolled in the study between April 1991 and March 1992. HIV tests were done using ELISA technique. Prevalence of HIV infection among the 93 patients was 53%. Average weight gain during treatment after 6 weeks was significantly lower in the HIV positive group. The mean time for sputum conversion was 13 weeks and 8 weeks in HIV positive and negative persons respectively. At time of discharge from the hospital after 2 months, 9 HIV positive patients reported marked improvement compared to 25 patients being HIV negative. Between April, 1991 and June 1992 24 patients with and 4 patients without HIV infection died. Drug related skin reactions were seen in 8 HIV positive and only one in HIV negative patient. 3 out of 13 TB patients with HIV infection tested for sensitivity showed primary resistance to thiacetazone and one to streptomycin. No resistance to tuberculostatic drugs was observed in the group without HIV infection. Our conclusions are that HIV positive TB patients don't respond well to standard TB chemotherapy. Therefore, short course treatment replacing thiacetazone and streptomycin should be promoted for all TB patients, who are living in high HIV prevalence areas.