RESUMEN
There is a little-noticed trend involving human immunodeficiency virus (HIV)-infected patients suspected of having tuberculosis: the triple-treatment regimen recommended in Brazil for years has been potentially ineffective in over 30% of the cases. This proportion may be attributable to drug resistance (to at least 1 drug) and/or to infection with non-tuberculous mycobacteria. This evidence was not disclosed in official statistics, but arose from a systematic review of a few regional studies in which the diagnosis was reliably confirmed by mycobacterial culture. This paper clarifies that there has long been ample evidence for the potential benefits of a four-drug regimen for co-infected patients in Brazil and it reinforces the need for determining the species and drug susceptibility in all positive cultures from HIV-positive patients.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Antituberculosos/administración & dosificación , Infecciones por Mycobacterium no Tuberculosas/epidemiología , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Brasil/epidemiología , Quimioterapia Combinada/métodos , Humanos , Prevalencia , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológicoRESUMEN
There is a little-noticed trend involving human immunodeficiency virus (HIV)-infected patients suspected of having tuberculosis: the triple-treatment regimen recommended in Brazil for years has been potentially ineffective in over 30 percent of the cases. This proportion may be attributable to drug resistance (to at least 1 drug) and/or to infection with non-tuberculous mycobacteria. This evidence was not disclosed in official statistics, but arose from a systematic review of a few regional studies in which the diagnosis was reliably confirmed by mycobacterial culture. This paper clarifies that there has long been ample evidence for the potential benefits of a four-drug regimen for co-infected patients in Brazil and it reinforces the need for determining the species and drug susceptibility in all positive cultures from HIV-positive patients.