Evolution of rifampin resistance in human immunodeficiency virus-associated tuberculosis

Charles M. Nolan, Diana L. Williams, M. Donald Cave, Kathleen D. Eisenach, Hiyam El-Hajj, Thomas M. Hooton, Robert L. Thompson, Stefan V. Coldberc

Research output: Contribution to journalArticlepeer-review

63 Scopus citations


Acquired rifampin resistance without preexisting isoniazid resistance is highly unusual in patients with tuberculosis. The purpose of this report is to describe and characterize that unusual pattern of acquired drug resistance in three patients with human immunodeficiency virus (HIV) infection. The patients originally had Mycobacterium tuberculosis strains that were susceptible to isoniazid and rifampin. During treatment in two patients and after completion of therapy in the remaining one, each patient developed active, rifampin-resistant, isoniazid-susceptible tuberculosis. One patient subsequently developed isoniazid resistance also. Studies on patients' M. tuberculosis isolates using IS6110 restriction fragment length polymorphism typing and rpoB gene sequencing indicated that rifampin resistance in each patient arose during therapy by an rpoB gene mutation in the original M. tuberculosis isolate. Detection of this unusual drug-resistance phenotype in three patients with HIV infection suggests that acquired rifampin resistance is somehow associated with co-infection due to HIV and tuberculosis.

Original languageEnglish (US)
Pages (from-to)1067-1071
Number of pages5
JournalAmerican journal of respiratory and critical care medicine
Issue number3
StatePublished - Sep 1995
Externally publishedYes

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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