Quantitative sputum bacillary load during rifampin-containing short course chemotherapy in human immunodeficiency virus-infected and non-infected adults with pulmonary tuberculosis

ABSTRACT

Setting: National Tuberculosis (TB) Treatment Centre; Mulago Hospital and Joint Clinical Research Centre; Kampala; Uganda. Objective: To compare the quantitative sputum bacillary load between TB patients infected with the human immunodeficiency virus (HIV) and those non-infected; during treatment with standard short course chemotherapy (SCC). Design: To comapre clinical characteristics and quantitative sputum bacillary load as measured by quantitative acid-fast bacilli (AFB) smears; colony forming unit (cfu) assay and time until positive culture in the BACTEC radiometric liquid system between 14 HIV-infected and 22 non-HIV-Infected adults with initial episodes of smear-positive polmunary TB at baseline and during treatment with standard four-drug SCC. Results: Other than cavitation (P=0.042) and adenopathy (P=0.03); which were more common among non-HIV-infected patients; respectively; there were no significant differences in baseline demographics; clinical; radiological and laboratory characteristics between the groups. Mean pretreatment sputum bacillary burden (6.5+/-0.51 log 10 AFB/ml; 5.91+/-0.91 log 10 cfu/ml and 1.8+/-1.7 days until positive BACTEC culture for HIV-infected patients and 6.32+/-0.85 log 10 AFB/ml; 5.58+/-0.68 log 10 cfu/ml and 1+/-1.2 days until positive BACTEC culture for non-HIV-infected patients) were comparable between HIV-infected and non-HIV-infected patients. Clinical bacteriological responses to standard SCC and treatment outcome did not differ between the groups. Conclusion: Quantitative sputum bacillary load at baseline and during SCC did not differ significantly between HIV-infected and non-HIV-Infected adults with initial episodes of smear - positive TB