• R Bwire, M W Borgdorff, V Sticht-Groh, H L Rieder, H J Kawuma, G Bretzel, and S Rüsch-Gerdes.
• St. Francis Leprosy Centre, Buluba, Uganda.
• East Afr Med J. 1999 Jun 1;76(6):307-13.

ObjectiveTo investigate if there is a difference in response to tuberculosis treatment between HIV seronegative and HIV seropositive patients following two months of intensive phase tuberculosis treatment.DesignProspective cohort study.SettingSt. Francis Leprosy Centre, south-east Uganda.SubjectsFour hundred fifty seven patients with never previously treated sputum smear-positive tuberculosis admitted during a two-year period in 1991/1993.InterventionIntensive phase treatment with streptomycin, isoniazid, rifampicin and pyrazinamide.Main Outcome MeasuresSputum conversion from a positive to a negative smear at eight weeks of treatment.ResultsHIV seropositivity prevalence was 28%. Among HIV seronegative patients, conversion to a negative smear status occurred in 76% persons compared to 78% in HIV seropositive patients. This difference was not statistically significant (OR = 0.9; 95% CI, 0.6-1.5). HIV seropositive patients, however, were more likely to die (p = 0.017). A high prevalence of resistance to isoniazid and streptomycin was found. Isoniazid resistance was more likely in HIV seronegative patients with M. tuberculosis strains compared to HIV seropositive persons (p < 0.005). Initial resistance to antituberculosis drugs did not have a significant effect on smear conversion.ConclusionThis study demonstrates that HIV-seropositive status is not a principal factor in delaying sputum conversion among patients receiving intensive phase tuberculosis treatment.

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