HIV doesn’t drive the spread of drug-resistant tuberculosis

While the human immunodeficiency virus (HIV) pandemic fuels tuberculosis (TB) outbreaks, it does not drive the development and transmission of multidrug-resistance in TB patients as previously suspected, according to an international study led by UCL scientists. The findings, published today in eLife, show that TB drug resistance is not more likely to evolve in HIV-positive patients compared to HIV-negative patients. 'We know that the HIV pandemic amplifies the TB epidemic as people are often co-infected but what wasn't clear before now was the effect of HIV on drug resistance of the agent of TB, the bacterium Mycobacterium tuberculosis (Mtb). We've shown for the first time that HIV is not the driver for multidrug-resistant TB,' said co-first author Dr Adrien Rieux (UCL Genetics Institute). 'There are ongoing efforts around the world to tackle these potentially fatal diseases and it is know that among the estimated 1.5 million people who died from TB in 2015, about 200,000 cases involved multidrug-resistant TB and 400,000 were HIV co-infected.' said co-first author Vegard Eldholm, a research fellow at the Norwegian Institute of Public Health. To explore the impact of HIV co-infection on Mtb drug resistance, the team analysed the genomes of 252 TB isolates from patients belonging to the largest outbreak of multidrug-resistant TB in South America to date. The isolates were collected from patients with known HIV status from the mid-1990s until 2009.