High Prevalence of Drug Resistance Amongst HIV-exposed and -Infected Children in a Tuberculosis Prevention Trial

Int J Tuberc Lung Dis. 2012 Feb;16(2):192-5. doi: 10.5588/ijtld.10.0795.


An emergence of drug-resistant tuberculosis (DR-TB) in settings affected by human immunodeficiency virus (HIV) and tuberculosis (TB) has been observed. We investigated the prevalence of DR-TB in P1041, a multicentered, randomised, double-blind trial which compared the administration of isoniazid (INH) to placebo, in HIV-exposed, non-infected and -infected African infants in the absence of any documented TB exposure. The prevalence of multidrug-resistant TB (MDR-TB) was 22.2% (95%CI 8.5-45.8) and INH monoresistance 5.6% (95%CI 0.1-27.6) among culture-confirmed cases, with all MDR-TB occurring in a single site. There was no association between INH treatment or placebo group, or between HIV infection status, and DR-TB prevalence. There was a high prevalence of DR-TB among HIV-exposed and -infected children. Surveillance of DR-TB among children in high-burden TB-HIV settings should be routine.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • HIV Infections / complications*
  • HIV Infections / epidemiology
  • HIV*
  • Humans
  • Infant
  • Isoniazid / administration & dosage
  • Isoniazid / therapeutic use
  • Male
  • Mycobacterium tuberculosis / isolation & purification
  • Prevalence
  • South Africa / epidemiology
  • Tuberculosis, Multidrug-Resistant / complications
  • Tuberculosis, Multidrug-Resistant / epidemiology*
  • Tuberculosis, Multidrug-Resistant / prevention & control
  • Young Adult


  • Antitubercular Agents
  • Isoniazid