ROLE OF HIV-INFECTION IN 67 PATIENTS WITH TUBERCULOSIS

This retrospective study compared the epidemiological, clinical and bacteriological characteristics of tuberculosis in HIV-infected (HIV+) and seronegative (HIV-) patients in France. It included 67 cases of tuberculosis observed in the hospital setting between 1985 and 1990. The 35 HIV+ patients (52.2 %) were more frequently of European origin, while those of African origin were HIV-. Disseminated tuberculosis predominated in HIV+ patients, as opposed to pulmonary tuberculosis in HIV- patients. The tuberculin test was more often positive in HIV-patients than in HIV+ ones (65,6 versus 17.1 % ; p < 0.001). Direct bacteriological examination of the sputum was positive more frequently in HIV- than HIV+ patients (56.2 versus 22.8 % ; p < 0.01). A high percentage of the Mycobacterium tuberculosis strains isolated from HIV+ patients (20 %) was resistant to anti-tuberculous drugs, primarily isoniazid, while no resistance was found in HIV- patients. The initial response to treatment and the therapy-associated side effects did not differ between the two groups. Four relapses (11.4 %) occured in HIV+ patients, raising the question of the indication of drug prophylaxis following tuberculosis in HIV-infected patients.