Aspects associated with drug resistance in people with tuberculosis/HIV: an integrative review

Abstract

Objective:

To analyze scientific productions on aspects associated with drug resistance in people with tuberculosis (TB)/HIV coinfection.

Methods:

Integrative literature review performed in the CINAHL, LILACS, SciELO, Web of Science, SCOPUS, MEDLINE and COCHRANE databases. The following descriptors were used in Portuguese, English and Spanish: HIV, Tuberculosis and Multidrug resistance. In total, 1,177 articles were found and 19 were selected; 1,158 were excluded, of which 41 were duplicates and 1,117 did not answer the research question and addressed other topics, namely: HIV and pneumonia coinfection; impact of multidrug resistance on the lives of people with coinfection, with emphasis on mortality; diagnostic tests for multidrug resistance; and association between HIV and meningeal tuberculosis.

Results:

Data were organized into three thematic categories, as follows: Clinical aspects, highlighting: HIV infection, hypoalbuminemia, elevated bacillus load; drug-related aspects, including treatment abandonment, non-adherence to therapy, previous treatment for tuberculosis, drug malabsorption, adverse effects caused by antiretroviral therapy, interaction between treatments for both infections; and social aspects, including hospitalizations, living with other people with multidrug-resistant bacilli, deprivation of liberty, delayed diagnosis and late start of treatment.

Conclusion:

The main aspects identified were abandonment of therapy, previous treatment for tuberculosis and inadequate intervention, and these results may also extend to people who do not have coinfection. This review is important to instigate new research, with emphasis on strategies focused on the early identification of people with multidrug resistance, prevention and encouragement of adherence to treatment.

Keywords
VIH; Tuberculosis; VIH infections; Acquired immunodeficiency syndrome; Drug resistance, multiple