225. Use of Genotype MTBDR Plus (HAIN Lifesciences) assay for the Diagnosis of Drug Resistant Tuberculosis in HIV and Tuberculosis co - infected Patients
Session: Poster Abstract Session: Diagnostics: Mycobacteriology
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • DrKartik.jpg (1015.8 kB)
  • Title: Use of Genotype MTBDR Plus (HAIN Lifesciences) assay for the Diagnosis of Drug Resistant Tuberculosis in HIV and Tuberculosis co - infected Patients.

    Background: The use of drug resistance assays to test for drug resistant tuberculosis in HIV and tuberculosis (TB) co-infection is rarely done in resource poor settings like India. We undertook this study to understand the prevalence and efficacy of this method in a tertiary care hospital in western India.

    Methods: HIV infected patients during the period of 2014 to 2016 were subjected to a WHO tuberculosis symptom score 3 monthly. Those patients with a positive result were exposed to a battery of investigations like basic blood biochemistry, imaging, biopsy and HAIN test. In all these patients baseline demographic data like age, sex, baseline CD4 count and hepatitis B status were recorded. The samples collected were sputum, pleural fluid, lymph node and intestinal biopsies.

    Results: We investigated 37 patients (23.3% females) with HIV and TB from 2014 to 2016. Median age of cohort was 40 and the median baseline CD4 count was 90 cells/mm3. 16 patients (43.24%) had Baseline tuberculosis of which 62.5% was extra pulmonary TB. 11 of these patients had a baseline HAIN test done which revealed 4 patients (25%) with incident drug resistant TB. In 30 patients with Incident TB (81%), 20 patients (66.67%) had pulmonary TB while the rest had pulmonary TB. 7 patients (23.3%) in the incident TB group were found to have multidrug resistant tuberculosis (see image 1).

    Conclusion: Drug resistant assays like HAIN test is a good tool for detecting multidrug resistant pulmonary and extra pulmonary TB. In HIV and TB co infections in a resource limited country like India, it can serve as an excellent tool to guide therapy in tuberculosis.

    Image 1: HAIN test for diagnosis of drug resistant TB

    Kartik Natarajan, MBBS, INTERNAL MEDICINE RESIDENT, Internal Medicine, POONA HOSPITAL AND RESEARCH CENTRE, PUNE, India, Ameet Dravid, MD, AAHIVS, HIV Medicine, Poona Hospital and Research Centre, PUNE, India and Arun Bahulikar, MD MEDICNE, Internal Medicine, Poona Hospital and Research Centre, pune, India

    Disclosures:

    K. Natarajan, None

    A. Dravid, None

    A. Bahulikar, None

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