Multidrug Resistance Tuberculosis in HIV Positive Patients

Multidrug resistant tuberculosis (MDR-TB) is a worldwide problem. In some countries over half of the tuberculosis isolates are resistant to rifampicin and isoniazid. Public health control measures and access to healthcare need to be strengthened and supported if the problem of MDR-TB lies to be solved. Appropriate environmental measures and rapid adequate treatment are necessary parts of any MDR-TB control strategy and early and accurate laboratory diagnosis may be possible using molecular genetic techniques. The most important predicting factor for MDR-TB is prior drug history but HIV has played an important part in MDR-TB outbreaks because of the frequent and rapid progression from exposure to disease in immunosuppressed patients. Early and appropriate drug therapy of patients can improve prognosis. Screening and contact tracing are important elements in the control of MDR-TB, but it is still unclear how close contacts should be managed.