       Document 0582
 DOCN  M9640582
 TI    Mycobacterial infection in HIV seropositive and seronegative
       populations, 1987-93.
 DT    9604
 AU    Taylor IK; Evans DJ; Coker RJ; Mitchell DM; Shaw RJ; Department of
       Respiratory Medicine, St Mary's Hospital Medical; School, London, UK.
 SO    Thorax. 1995 Nov;50(11):1147-50. Unique Identifier : AIDSLINE
       MED/96149317
 AB    BACKGROUND--Although the causes of the worldwide resurgence of
       tuberculosis are multifactorial, the HIV epidemic is believed to have
       had a central role. Control is further threatened by the emergence of
       multidrug-resistant tuberculosis. METHODS--A retrospective evaluation
       was undertaken of trends in pulmonary and extrapulmonary culture
       positive mycobacterial pathology, and the prevalence of drug-resistant
       tuberculosis in both HIV seropositive and, presumptively, HIV
       seronegative patients receiving their clinical care at St Mary's
       Hospital, London. Five hundred and thirty eight patients (188 of whom
       were known to be HIV seropositive) with positive mycobacterial isolates
       between January 1987 and March 1993 were identified from laboratory
       records. These were cross referenced with drug surveillance records.
       RESULTS--Overall, between 1987 and 1992 there was a progressive 3.5 fold
       increase in positive mycobacterial isolates and a 2.5 fold increase in
       patients with proven mycobacterial infection. This increase was greater
       within the HIV seropositive population. A total of 663 positive
       mycobacterial isolates was evaluated; the major pathogen identified was
       Mycobacterium tuberculosis (379 isolates, 57%). Three hundred and
       fourteen patients were diagnosed as having M tuberculosis, 49 of whom
       were HIV seropositive. M tuberculosis was predominantly isolated from
       the lung. Of 358 positive cultures for M tuberculosis (68 HIV
       seropositive, 290 presumptively HIV seronegative), only 27 isolates
       (7.6%), almost exclusively derived from presumed HIV seronegative
       patients, were resistant to either isoniazid, rifampicin, or both drugs
       together. No increases in drug-resistant isolates were observed over
       this period. CONCLUSIONS--There has been a considerable increase in the
       incidence of tuberculosis in both HIV seronegative and seropositive
       populations during the study period. The emergence of drug-resistant
       tuberculosis was not observed.
 DE    Adolescence  Adult  Aged  Aged, 80 and over  Child  Child, Preschool
       Female  Human  *HIV Seronegativity  HIV
       Seropositivity/*COMPLICATIONS/MICROBIOLOGY  Male  Middle Age
       Mycobacterium/ISOLATION & PURIF  Mycobacterium
       Infections/*COMPLICATIONS/EPIDEMIOLOGY/IMMUNOLOGY  Prevalence
       Retrospective Studies  Tuberculosis/COMPLICATIONS  Tuberculosis,
       Multidrug-Resistant/COMPLICATIONS  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

