Pulmonary tuberculosis: Virulence of Mycobacterium africanum and relevance in HIV co-infection
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Date
2008
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Abstract
Although Mycobacterium africanum is being isolated in a significant proportion of cases of
pulmonary tuberculosis in West Africa, its pathogenic potential remains a matter of discussion.
Recent reports leave the question of whether M. africanum causes more severe pathology than
M. tuberculosis or resembles opportunistic pathogens and might gain importance in the course
of the HIV pandemic.
Patients with pulmonary tuberculosis associated withM. africanum (n Z 556) and M. tuberculosis
(n Z 1350) were studied in Ghana, West Africa, and compared regarding self-reported signs and
symptoms, chest radiography, HIV status, mycobacterial drug resistance and mycobacterial
clustering as determined by spoligotyping and IS6110 fingerprints.
The rate of M. africanum infections was similar in HIV-positive (27%) and HIV-negative (30%)
patients. M. africanum clustered less than M. tuberculosis (21% vs 79%; OR, 0.38; 95% CI, 0.3e0.5;
p < 0.001) corresponding to its lower prevalence (29% vs 70%).
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