Quantitative sputum bacillary load during rifampin-containing short coursechemotherapy in human immunodeficiency virus-infected and non-infected adults with pulmonary tuberculosis

SETTING: National Tuberculosis (TB) Treatment Centre, Mulago Hospital and J oint Clinical Research Centre, Kampala, Uganda. OBJECTIVE: TO compare the quantitative sputum bacillary load between TB pat ients infected with the human immunodeficiency virus (HN) and those non-inf ected, during treatment with standard short course chemotherapy (SCC). DESIGN: TO compare clinical characteristics and quantitative sputum bacilla ry load as measured by quantitative acid-fast bacilli (AFB) smears, colony forming unit (cfu) assay and time until positive culture in the BACTEC(R) r adiometric liquid system between 14 HIV/infected and 22 non-HIV-infected ad ults with initial episodes of smear-positive pulmonary TB at baseline and d uring treatment with standard four-drug SCC. RESULTS: Other than cavitation (P = 0.042) and adenopathy (P = 0.03), which were more common among non-HIV-infected and HIV-infected patients, respect ively, there were no significant differences in baseline demographic, clini cal, radiological and laboratory characteristics between the groups. Mean p retreatment sputum bacillary burden (6.5 +/- 0.51 log(10) AFB/ml, 5.91 +/- 0.91 log(10) cfu/ml and 1.8 +/- 1.7 days until positive BACTEC(R) culture f or HIV-infccted patients and 6.32 +/- 0.85 log(10) AFB/ml, 5.58 +/- 0.68 lo g(10) cfu/ml and 1.9 +/- 1.2 days until positive BACTEC(R) culture for non- HIV-infected patients) were comparable between HIV-infected and non-HIV-inf ected patients. Clinical and bacteriological responses to standard SCC and treatment outcome did not differ between the groups. CONCLUSION: Quantitative sputum bacillary load at baseline and during SCC d id not differ significantly between HIV-infected and non-HIV-infected adult s; with initial episodes of smear-positive TB.