ROLE OF HIV-INFECTION IN 67 PATIENTS WITH TUBERCULOSIS

This retrospective study compared the epidemiological, clinical and ba cteriological characteristics of tuberculosis in HIV-infected (HIV+) a nd seronegative (HIV-) patients in France. It included 67 cases of tub erculosis observed in the hospital setting between 1985 and 1990. The 35 HIV+ patients (52.2 %) were more frequently of European origin, whi le those of African origin were HIV-. Disseminated tuberculosis predom inated 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 bacteriolog ical examination of the sputum was positive more frequently in HIV- th an HIV+ patients (56.2 versus 22.8 % ; p < 0.01). A high percentage of the Mycobacterium tuberculosis strains isolated from HIV+ patients (2 0 %) was resistant to anti-tuberculous drugs, primarily isoniazid, whi le no resistance was found in HIV- patients. The initial response to t reatment and the therapy-associated side effects did not differ betwee n the two groups. Four relapses (11.4 %) occured in HIV+ patients, rai sing the question of the indication of drug prophylaxis following tube rculosis in HIV-infected patients.