Publication
Title
Is HIV infection a risk factor for multi-drug resistant tuberculosis? A systematic review
Author
Abstract
Background: Tuberculosis ( TB) is an important cause of human suffering and death. Human immunodeficiency virus (HIV), multi-drug resistant TB (MDR-TB), and extensive drug resistant tuberculosis (XDR-TB) have emerged as threats to TB control. The association between MDR-TB and HIV infection has not yet been fully investigated. We conducted a systematic review and meta-analysis to summarize the evidence on the association between HIV infection and MDR-TB. Methods and Results: Original studies providing Mycobacterium tuberculosis resistance data stratified by HIV status were identified using MEDLINE and ISI Web of Science. Crude MDR-TB prevalence ratios were calculated and analyzed by type of TB (primary or acquired), region and study period. Heterogeneity across studies was assessed, and pooled prevalence ratios were generated if appropriate. No clear association was found between MDR-TB and HIV infection across time and geographic locations. MDR-TB prevalence ratios in the 32 eligible studies, comparing MDR-TB prevalence by HIV status, ranged from 0.21 to 41.45. Assessment by geographical region or study period did not reveal noticeable patterns. The summary prevalence ratios for acquired and primary MDR-TB were 1.17 (95% CI 0.86, 1.6) and 2.72 (95% CI 2.03, 3.66), respectively. Studies eligible for review were few considering the size of the epidemics. Most studies were not adjusted for confounders and the heterogeneity across studies precluded the calculation of a meaningful overall summary measure. Conclusions: We could not demonstrate an overall association between MDR-TB and HIV or acquired MDR-TB and HIV, but our results suggest that HIV infection is associated with primary MDR-TB. Future well-designed studies and surveillance in all regions of the world are needed to better clarify the relationship between HIV infection and MDR-TB.
Language
English
Source (journal)
PLoS ONE
Publication
San francisco : Public library science , 2009
ISSN
1932-6203
DOI
10.1371/JOURNAL.PONE.0005561
Volume/pages
4 :5 (2009) , 9 p.
Article Reference
e5561
ISI
000266107400005
Medium
E-only publicatie
Full text (Publisher's DOI)
Full text (open access)
UAntwerpen
Publication type
Subject
External links
Web of Science
Record
Identifier
Creation 15.02.2018
Last edited 31.01.2023
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