American Journal of Internal Medicine

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Resistant Tuberculosis in HIV-Positive Patients: A Growing Public Health Threat

Received: 17 April 2023    Accepted: 19 May 2023    Published: 31 May 2023
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Abstract

Introduction: Tuberculosis (TB) is a pathology considered one of the main causes of death by single infectious agent, ranking just after HIV / AIDS. Indeed, its emergence and the difficulty of its treatment, especially in the resistant form, in patients with co-infection with other diseases immundéprimante as HIV. Observation 1: 31 years old presented with febrile headaches complicated by epileptic seizures. The MRI scan showed 3 cockeyed and multilocular lesions suggesting neuromeningeal tuberculosis. HIV serology came back positive and during the first line treatment he relapsed and the resistance test was positive. Observation 2: 45 progressive alteration of the state associated with signs of tuberculosis impregnation and a meningeal syndrome. BK in the CSF and in the sputum was positive and brain imaging allowed us to retain the diagnosis of a neuromeningeal tuberculosis. The patient was put on anti-bacillary ERIP k4 and a corticotherapy. The workup for co-infection was able to establish an HIV infection. After 3 weeks of anti-bacillary treatment, the patient had a bad evolution and the search for resistance came back positive. Observation 3: 25 years old, pulmonary tuberculosis manifested by a hemoptysis of small abundance associated with a deep alteration of the general state, 3 BK positive sputum, as well as the image of a tuberculous cavern on the thoracic CT. Bad evolution after 2 months of treatment of first worsening of symptoms neuro and systemic involvement the search for resistance came back positive. Discussion: Drug-resistant tuberculosis is a major global public health challenge. In this article, we present three cases of drug-resistant TB in HIV-coinfected patients, highlighting the emergence and increasing prevalence of multidrug-resistant TB (MDR-TB) strains worldwide. In order to control the spread of this dreaded disease, it is essential to improve treatment regimens, promote vaccination, educate affected patients, and promote adherence to treatment. conclusion: Diagnosis of drug-resistant tuberculosis should be prompt and considered if there is a delay or lack of improvement with conventional tuberculosis treatment.

DOI 10.11648/j.ajim.20231103.15
Published in American Journal of Internal Medicine (Volume 11, Issue 3, May 2023)
Page(s) 55-59
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Tuberculosis, Co-infection, HIV, Drug Resistance, Mutations, Susceptibility, New Treatment Regimens, Prevention

References
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  • APA Style

    Safae Elfirdaous Fari, Maamar Mouna, Khibri Haja, Nisserine Jait, Youssra Moussadik, et al. (2023). Resistant Tuberculosis in HIV-Positive Patients: A Growing Public Health Threat. American Journal of Internal Medicine, 11(3), 55-59. https://doi.org/10.11648/j.ajim.20231103.15

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    ACS Style

    Safae Elfirdaous Fari; Maamar Mouna; Khibri Haja; Nisserine Jait; Youssra Moussadik, et al. Resistant Tuberculosis in HIV-Positive Patients: A Growing Public Health Threat. Am. J. Intern. Med. 2023, 11(3), 55-59. doi: 10.11648/j.ajim.20231103.15

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    AMA Style

    Safae Elfirdaous Fari, Maamar Mouna, Khibri Haja, Nisserine Jait, Youssra Moussadik, et al. Resistant Tuberculosis in HIV-Positive Patients: A Growing Public Health Threat. Am J Intern Med. 2023;11(3):55-59. doi: 10.11648/j.ajim.20231103.15

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  • @article{10.11648/j.ajim.20231103.15,
      author = {Safae Elfirdaous Fari and Maamar Mouna and Khibri Haja and Nisserine Jait and Youssra Moussadik and Thameen Jaradat and Wafae Ammouri and Naima Moutassim and Hicham Harmouche and Zoubida Mezalek Tazi and Mohamed Adnoui},
      title = {Resistant Tuberculosis in HIV-Positive Patients: A Growing Public Health Threat},
      journal = {American Journal of Internal Medicine},
      volume = {11},
      number = {3},
      pages = {55-59},
      doi = {10.11648/j.ajim.20231103.15},
      url = {https://doi.org/10.11648/j.ajim.20231103.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20231103.15},
      abstract = {Introduction: Tuberculosis (TB) is a pathology considered one of the main causes of death by single infectious agent, ranking just after HIV / AIDS. Indeed, its emergence and the difficulty of its treatment, especially in the resistant form, in patients with co-infection with other diseases immundéprimante as HIV. Observation 1: 31 years old presented with febrile headaches complicated by epileptic seizures. The MRI scan showed 3 cockeyed and multilocular lesions suggesting neuromeningeal tuberculosis. HIV serology came back positive and during the first line treatment he relapsed and the resistance test was positive. Observation 2: 45 progressive alteration of the state associated with signs of tuberculosis impregnation and a meningeal syndrome. BK in the CSF and in the sputum was positive and brain imaging allowed us to retain the diagnosis of a neuromeningeal tuberculosis. The patient was put on anti-bacillary ERIP k4 and a corticotherapy. The workup for co-infection was able to establish an HIV infection. After 3 weeks of anti-bacillary treatment, the patient had a bad evolution and the search for resistance came back positive. Observation 3: 25 years old, pulmonary tuberculosis manifested by a hemoptysis of small abundance associated with a deep alteration of the general state, 3 BK positive sputum, as well as the image of a tuberculous cavern on the thoracic CT. Bad evolution after 2 months of treatment of first worsening of symptoms neuro and systemic involvement the search for resistance came back positive. Discussion: Drug-resistant tuberculosis is a major global public health challenge. In this article, we present three cases of drug-resistant TB in HIV-coinfected patients, highlighting the emergence and increasing prevalence of multidrug-resistant TB (MDR-TB) strains worldwide. In order to control the spread of this dreaded disease, it is essential to improve treatment regimens, promote vaccination, educate affected patients, and promote adherence to treatment. conclusion: Diagnosis of drug-resistant tuberculosis should be prompt and considered if there is a delay or lack of improvement with conventional tuberculosis treatment.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Resistant Tuberculosis in HIV-Positive Patients: A Growing Public Health Threat
    AU  - Safae Elfirdaous Fari
    AU  - Maamar Mouna
    AU  - Khibri Haja
    AU  - Nisserine Jait
    AU  - Youssra Moussadik
    AU  - Thameen Jaradat
    AU  - Wafae Ammouri
    AU  - Naima Moutassim
    AU  - Hicham Harmouche
    AU  - Zoubida Mezalek Tazi
    AU  - Mohamed Adnoui
    Y1  - 2023/05/31
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ajim.20231103.15
    DO  - 10.11648/j.ajim.20231103.15
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 55
    EP  - 59
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20231103.15
    AB  - Introduction: Tuberculosis (TB) is a pathology considered one of the main causes of death by single infectious agent, ranking just after HIV / AIDS. Indeed, its emergence and the difficulty of its treatment, especially in the resistant form, in patients with co-infection with other diseases immundéprimante as HIV. Observation 1: 31 years old presented with febrile headaches complicated by epileptic seizures. The MRI scan showed 3 cockeyed and multilocular lesions suggesting neuromeningeal tuberculosis. HIV serology came back positive and during the first line treatment he relapsed and the resistance test was positive. Observation 2: 45 progressive alteration of the state associated with signs of tuberculosis impregnation and a meningeal syndrome. BK in the CSF and in the sputum was positive and brain imaging allowed us to retain the diagnosis of a neuromeningeal tuberculosis. The patient was put on anti-bacillary ERIP k4 and a corticotherapy. The workup for co-infection was able to establish an HIV infection. After 3 weeks of anti-bacillary treatment, the patient had a bad evolution and the search for resistance came back positive. Observation 3: 25 years old, pulmonary tuberculosis manifested by a hemoptysis of small abundance associated with a deep alteration of the general state, 3 BK positive sputum, as well as the image of a tuberculous cavern on the thoracic CT. Bad evolution after 2 months of treatment of first worsening of symptoms neuro and systemic involvement the search for resistance came back positive. Discussion: Drug-resistant tuberculosis is a major global public health challenge. In this article, we present three cases of drug-resistant TB in HIV-coinfected patients, highlighting the emergence and increasing prevalence of multidrug-resistant TB (MDR-TB) strains worldwide. In order to control the spread of this dreaded disease, it is essential to improve treatment regimens, promote vaccination, educate affected patients, and promote adherence to treatment. conclusion: Diagnosis of drug-resistant tuberculosis should be prompt and considered if there is a delay or lack of improvement with conventional tuberculosis treatment.
    VL  - 11
    IS  - 3
    ER  - 

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Author Information
  • Department of Internal Medicine Avicenne, University Hospital, Rabat, Morocco

  • Department of Internal Medicine Avicenne, University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Hospital, Rabat, Morocco

  • Department of Internal Medicine Avicenne, University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Hospital, Rabat, Morocco

  • Department of Internal Medicine Avicenne, University Hospital, Rabat, Morocco

  • Department of Internal Medicine Avicenne, University Hospital, Rabat, Morocco

  • Department of Neurosurgery, Avicenne University Hospital, Rabat, Morocco

  • Department of Internal Medicine Avicenne, University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Hospital, Rabat, Morocco

  • Department of Internal Medicine Avicenne, University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Hospital, Rabat, Morocco

  • Department of Internal Medicine Avicenne, University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Hospital, Rabat, Morocco

  • Department of Internal Medicine Avicenne, University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Hospital, Rabat, Morocco

  • Department of Internal Medicine Avicenne, University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, University Hospital, Rabat, Morocco

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