| Full text | |
| Author(s): |
Elizabete Abrantes Nunes
[1]
;
Eduardo Mello De Capitani
[2]
;
Elizabete Coelho
[3]
;
Alessandra Costa Panunto
[4]
;
Orvalho Augusto Joaquim
[5]
;
Marcelo de Carvalho Ramos
[6]
Total Authors: 6
|
| Affiliation: | [1] Eduardo Mondlane University. School of Medicine - Moçambique
[2] State University at Campinas. School of Medical Sciences. Department of Pulmonology - Brasil
[3] Maputo Central Hospital. Molecular Biology Laboratory - Moçambique
[4] State University at Campinas. School of Medical Sciences. Laboratory of Mycobacterial Study - Brasil
[5] Eduardo Mondlane University. School of Medicine. Department of Community Health - Moçambique
[6] State University at Campinas. School of Medical Sciences - Brasil
Total Affiliations: 6
|
| Document type: | Journal article |
| Source: | Jornal Brasileiro de Pneumologia; v. 34, n. 10, p. 822-828, 2008-10-00. |
| Field of knowledge: | Health Sciences - Collective Health |
| Abstract | |
OBJECTIVE: Mycobacteriosis is frequently diagnosed among HIV-infected patients. In Mozambique, where few patients are under antiretroviral therapy and the prevalence of tuberculosis is high, there is need for better characterization of mycobacteria at the species level, as well as for the identification of patterns of resistance to antituberculous drugs. METHODS: We studied a sample of 503 HIV-infected individuals suspected of having pulmonary tuberculosis. Of those 503, 320 tested positive for mycobacteria through sputum smear microscopy or culture of bronchoalveolar lavage fluid. RESULTS: Acid-fast bacilli were observed in the sputum of 73% of the individuals presenting positive cultures. Of 277 isolates tested, only 3 were nontuberculous mycobacteria: 2 were identified as Mycobacterium avium and one was identified as M. simiae. Strains initially characterized as M. tuberculosis complex through polymerase chain reaction restriction analysis (PRA) of the hsp65 gene were later confirmed as such through PRA of the gyrB gene. Among the M. tuberculosis isolates, resistance patterns were as follows: to isoniazid, 14%; to rifampin, 6%; and multidrug resistance, 5%. Previously treated cases showed significantly higher rates of resistance to first-line antituberculous drugs. The most common radiological pattern was interstitial infiltrate (in 67%), followed by mediastinal lymph node enlargement (in 30%), bronchiectasis (in 28%), miliary nodules (in 18%) and cavitation (in 12%). Patients infected with nontuberculous mycobacteria presented clinical profiles indistinguishable from those of other patients. The median CD4 lymphocyte count in this group was 134 cells/mm³. CONCLUSIONS: There is a strong association between tuberculosis and AIDS in Mozambique, as expected in a country with a high prevalence of tuberculosis. Although drug resistance rates are high, the isoniazid-rifampin regimen continues to be the appropriate choice for initial therapy. (AU) | |