Pattern of Multi-Drug Resistant Tuberculosis in HIV Sero Positive Patients in Rivers State Nigeria

Background: Tuberculosis (TB) presents a major worldwide health concern, especially in immune-suppressed persons, with a high mortality rate. The emergence of drug-resistant variants of TB further weighted down by the high HIV prevalence continues to make it difficult to treat this disease. Nigeria is currently listed among the 30 high burden countries for TB, TB/HIV and drug resistant TB (DR-TB). The current study assessed the resistant patterns of Mycobacterium tuberculosis to first-line anti-TB drugs among individuals with tuberculosis and HIV coinfection in Rivers State.

Methods: A sample size of 260 HIV sero-positive patients were separated into two groups consisting of 130 patients on anti-TB treatment and 130 individuals yet to commence anti-TB treatment. Sputum samples were collected and processed by line probe assay (GenoType®MTBDRplus by HAIN Lifescience).

Results: The study showed that about 61.5% of the subjects with TB/HIV coinfection were between the ages of 26 and 40 years, with a mean age of 37.2 ± 9.6 years, (102) 64.1% of the subjects had drug susceptible TB, 24 (15%) had INH mono-resistant TB, 17 (10.7%) had RIF mono-resistant TB and 16 (10.1%) had multi-drug resistant TB. There was no significant difference observed in the occurrence of drug resistance between the different sexes. The results also showed that 11.0% of the individuals receiving anti-TB treatment had MDR-TB; INH and RIF mono-resistance were observed in 15.7% and 11.8% of these subjects respectively. Amongst subjects that were yet to receive anti-TB treatment, 6.3% had MDR-TB, 12.5% had INH mono-resistant and 6.3% had RIF mono-resistant TB.

Conclusion: The findings of the study indicate that drug-resistant TB appears to be prevalent among persons with TB/HIV coinfection in Rivers State, Nigeria.