Study of HIV Seroprevalence in Pulmonary Tuberculosis Patients with Special Reference to Multidrug Resistant Mycobacteria

This study was planned to determine HIV seroprevalence among pulmonary tuberculosis patients, to characterize the isolated mycobacteria into typical and atypical strains and to evaluate the drug resistant pattern of mycobacterial isolates. The study aims to correlate multidrug resistance (MDR) and HIV seropositivity status in pulmonary tuberculosis patients. During the year 1994-1997, 750 pulmonary TB patients were screened for the presence of anti- HIV 1 & 2 antibodies by commercially available kits of enzyme immunoassay (EIA). Sputum samples were screened for acid fast bacteria by Ziehl-Neelsen technique and isolated on Lowenstein-Jensen (LJ) media. Identification of M. tuberculosis was done by standard biochemical tests. Drug sensitivity testing was carried out using a standard inoculum onto LJ slopes containing different concentrations of 5 anti-TB drugs, namely isoniazid, rifampicin, ethambutol, streptomycin and ethionamide. Out of 750 patients screened, 177 (23.6%) were detected to be HIV seropositive (Group I) and 573 were seronegative cases (Group II). Among these 2 groups, 135 (76.27%) and 473 (82.55%) patients yielded mycobacterial cultures on LJ slopes respectively. Drug sensitive testing revealed 25.19% and 12.05% isolates to be resistant to all the 3 first line drugs namely, rifampicin, isoniazid and ethambutol in seropositive and seronegative groups respectively. From our study it is evident that multidrug resistance has shown a marked increase to the first line anti-TB drugs in HIV seropositive pulmonary tuberculosis patients.