Current HIV seroprevalence rate and incidence of adverse skin reactions in adults with pulmonary tuberculosis receiving thiacetazone-free antituberculosis treatment in Yaounde, Cameroon

Abstract

Objectives: To determine the current HIV seroprevalence in adult patients with pulmonary tuberculosis in Yaounde and to compare the incidence of adverse skin reactions in these patients with and without HIV infection receiving thiacetazone-free antituberculosis treatment.

Design: Case series.

Setting: Chest clinic of Hospital Jamot in Yaounde, Cameroon.

Subjects: 235 consecutive patients aged > or = 15 years with a diagnosis of pulmonary tuberculosis from July 1 to December 31, 1994.

Main outcome measures: HIV seroprevalence and incidence of adverse skin reactions to antituberculosis treatment.

Results: Of the 235 patients studied, 156 (66%) were male (mean age: 33 range 17 to 84 years) and 79 were female (mean age: 30.3, range 16 to 64 years). Overall 16.6% (39 cases) of the 235 patients were HIV seropositive. The prevalence of HIV infection was significantly higher in women (24%) than in men (12.5%) (p = 0.045). Adverse skin reactions to antituberculosis treatment were observed in 11 (4.7%) of the 235 patients. The incidence of the reactions was significantly higher in HIV seropositive (23.1%) than HIV seronegative patients (1.0%) (p < 0.001). Two HIV seropositive patients who developed Steven-Jonson syndrome died. The drugs incriminated for adverse skin reactions in the nine patients who survived were pyrazinamide (four cases) and rifampicin (five cases).

Conclusion: HIV infected patients on antituberculosis drug should be monitored for adverse skin reactions which are sometimes fatal.