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J Med Microbiol 57 (2008), 190-197; DOI: 10.1099/jmm.0.47492-0
© 2008 Society for General Microbiology
ISSN 1473-5644

Human immunodeficiency virus and tuberculosis in Argentina: prevalence, genotypes and risk factors

Maria A. Pando1, Cristina De Salvo2, Christian T. Bautista3, Lindsay Eyzaguirre4, Gladys Carrion5, Miguel Feola6, Isabel Lado7, Marta Hoffman8, Mirna M. Biglione1,9, Jean K. Carr4, Silvia M. Montano5, José L. Sanchez10,11, Mercedes Weissenbacher1,9 and Maria M. Avila1,9

1 Centro Nacional de Referencia para el SIDA, Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Piso 11, C1121ABG, Buenos Aires, Argentina

2 Division Neumotisiologia, Hospital General de Agudos Dr Enrique Tornu, Donato Alvarez 3002, 1406 Buenos Aires, Argentina

3 US Military HIV Research Program at the Walter Reed Army Institute of Research, 1 Taft Court, Suite 250, Rockville, MD 20850, USA

4 Department of Epidemiology, Institute of Human Virology, University of Maryland Biotechnology Institute, 725 W. Lombard Street, Baltimore, MD 21201, USA

5 US Naval Medical Research Center Detachment (NMRCD), Unit 3800, APO-AA 34031-3800 Lima, Peru

6 Tisioneumonologia, Hospital Gral. de Agudos Carlos C. Durand, Av. Díaz Vélez 5044, 1405, Buenos Aires, Argentina

7 Servicio de Medicina Preventiva, Hospital Gral. Bernardino Rivadavia, Gral. Las Heras 2670, 1425, Buenos Aires, Argentina

8 Laboratory, Microbiology Unit, Hospital General de Agudos Dr. Enrique Tornu, Donato Alvarez 3002, 1406, Buenos Aires, Argentina

9 CONICET, Argentina

10 Department of Defense Global Emerging Infections Surveillance and Response System (DoD-GEIS), Walter Reed Army Institute of Research, 2900 Linden Lane, Suite 103, Silver Spring, MD 20910, USA

11 Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Rockville, MD 20852, USA

Correspondence
Maria A. Pando
mpando{at}fmed.uba.ar

Received 3 July 2007
Accepted 10 October 2007

The objective of this study was to determine the prevalence and genetic variability of human immunodeficiency virus type 1 (HIV-1) and other sexually transmitted infections (STIs) among 205 patients with clinical diagnosis of tuberculosis (TB) in Buenos Aires in 2001. Infections with hepatitis B virus (HBV), HIV-1, hepatitis C virus (HCV), Treponema pallidum and human T-cell lymphotropic virus types I/II were diagnosed in 37/187 (19.8 %), 35/205 (17.1 %), 22/187 (11.8 %), 13/187 (7.0 %) and 4/181 (2.2 %) patients, respectively. Almost one in three participants (33.1 %) presented at least one infection in addition to TB. Multiresistance to TB drugs (isoniazid plus rifampicin) was detected in the isolates recovered from three patients. Injecting drug use was detected as the main risk factor for HIV, HBV and HCV infections. Of ten patients who died, eight were infected with HIV. HIV genetic characterization showed the presence of two different subtypes. Env subtype F was found in 13/24 samples (54.2 %) and subtype B in 11/24 samples (45.8 %) by heteroduplex mobility assay. Sequencing of the protease/RT region was performed in ten samples: three were characterized as subtype B and seven as B/F recombinants by bootscanning analysis. Phylogenetic analysis of four full-length sequences showed that three were the circulating recombinant form CRF12_BF. The results of this study suggest an urgent need to detect HIV infection in high-risk groups to prevent future HIV transmission as well as morbidity and mortality associated with TB by providing highly active antiretroviral therapy (HAART) and/or TB treatment. Collaboration between TB and HIV programmes seems to be the best approach to decrease the incidence of these diseases, especially in high-prevalence HIV settings.

Abbreviations: AIDS, acquired immunodeficiency syndrome; HMA, heteroduplex mobility assay; IDU, intravenous drug user; OR, odds ratio; RT, reverse transcriptase; STI, sexually transmitted infection; TB, tuberculosis.






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