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[Characteristics of tuberculosis in a general hospital during the period 1993-1998. Analysis of resistance and HIV coinfection].

AIM
The epidemiologic and clinical characteristics, presence of HIV coinfection, and sensitivity to tuberculostatic drugs were analyzed in a series of tuberculosis patients attended in our center.


PATIENTS AND METHODS
Retrospective study of tuberculosis cases attended in a third- level hospital from 1993 to 1998.


RESULTS
During the study period, 268 cases of tuberculosis were diagnosed in our center. A progressive decrease in the incidence of this disease has occurred since 1995. Among the jailed population, we also found a decrease in cases of tuberculosis and there were no cases of resistance. In the total population, only 8 isolates (3.27%) showed resistance to some of the antituberculosis drugs studied (isoniazid, rifampicin, ethambutol, streptomycin). A tendency toward a decrease in resistance was also observed starting from 1995, with no new cases detected in the last two years. There was a 1.3% rate of primary resistance to isoniazid. Multiresistance was detected in only 4 patients, two of whom died. The rate of HIV coinfection was 38.8%. In 39% of cases the form of presentation was exclusively pulmonary and in 25% it was disseminated.


CONCLUSIONS
There was a 50% decrease in tuberculosis cases during the period studied. The rate of HIV coinfection was 38.8%, one of the highest in the literature, indicating that HIV serology should be included in the protocol for studying tuberculosis in our setting. Given the low rate of resistance detected, we recommend a three-drug regimen for antituberculosis treatment.