These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Cohort study of HIV-positive and HIV-negative tuberculosis, Nairobi, Kenya: comparison of bacteriological results.
    Author: Githui W, Nunn P, Juma E, Karimi F, Brindle R, Kamunyi R, Gathua S, Gicheha C, Morris J, Omwega M.
    Journal: Tuber Lung Dis; 1992 Aug; 73(4):203-9. PubMed ID: 1477386.
    Abstract:
    We have set up a cohort of human immunodeficiency virus (HIV) positive and negative patients with tuberculosis in order to address the problems associated with HIV-related tuberculosis. We present here the results of sputum smear microscopy, culture, mycobacterial identification tests and drug susceptibility assays from specimens taken at presentation. In this selected population of largely pulmonary tuberculosis cases, HIV infection is not associated with significant differences in sputum smear positivity rate, culture positivity rate or initial drug resistance. No atypical mycobacteria were found. Direct sputum smear examination remains specific for the diagnosis of tuberculosis in Kenya in spite of the presence of HIV. HIV infection was not associated with an increase in the proportion of pulmonary cases still culture-positive at 6 months. However a significant increase in the proportion of cases still culture-positive at 6 months was seen in those with initially resistant strains and also in those treated with standard regimen (streptomycin, thiacetazone and isoniazid for 1 month followed by thiacetazone and isoniazid for 11 months, 1STH/11TH) rather than a short-course, rifampicin-containing regimen (rifampicin, pyrazinamide and isoniazid for 2 months, together with streptomycin for the first month and followed by 6 months of thiacetazone and isoniazid, SHRZ/6TH). A study of HIV-related tuberculosis (TB) in Kenya was conducted by analyzing all cases of new suspected TB presenting from April 1989 through May 1990 at the Infectious Disease Hospital and the Ngaira Avenue Chest Clinic. There were 355 cases, 117 of whom were HIV+. No atypical mycobacteria were isolated. There were no significant differences between HIV+ and HIV-patients as to colony counts, grading of sputum smears or prevalence of drug-resistant strains initially. HIV infection was not associated with a significantly increased proportion of pulmonary TB cases still culture positive at 6 months. However, there was a significant increase in the proportion of cases still culture-positive at 6 months among those who initially had drug resistant strains and who were treated with the standard drug regimen (streptomycin, thiacetazone and isoniazid for 1 month, then thiacetazone and isoniazid for 11 months). The discussion enumerated several factors potentially effecting selection of the high proportion of pulmonary TB patients in this series. Direct sputum smear remains specific for diagnosis of TB in Kenya in spite of HIV. These results still suggest that HIV+ pulmonary TB responds well to standard anti-TB therapy.
    [Abstract] [Full Text] [Related] [New Search]