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Drug-resistant TB

TB that is resistant to isoniazid and rifampicin, and to other drugs as well, is becoming much more common. This is called multidrug-resistant TB (MDR-TB) and cases have been seen in HIV-positive people.

Unlike drug-sensitive TB, which is normally cured, the risk of dying from multidrug-resistant TB is higher, unless you very quickly receive treatment consisting of anti-TB drugs that still work.

In the early 1990s, there were outbreaks of multidrug-resistant TB on HIV wards in two UK hospitals but, thanks to effective infection-control measures, there has not been an outbreak for many years.

To help control the spread of multidrug-resistant TB, it is often necessary for a person with it to stay in hospital in isolation, until treatment has started to be effective.

Treating multidrug-resistant TB is much harder than treating normal drug-sensitive TB. People who have it need to take more anti-TB drugs for longer. Treatment for up to two years or in some cases even longer may be required. Drugs used to treat multidrug-resistant TB include streptomycin, kanamycin, clarithromycin, amikacin, capreomycin, and quinolones.

Some of these drugs can also interact with anti-HIV medication or have unpleasant side-effects and close monitoring is needed.  It is very important that you complete the whole course of treatment, so do talk to your doctor about side-effects and what can be done to make them easier to manage.

Multidrug-resistant TB is more difficult to treat, so it is likely you will be referred to a doctor who specialises in treating TB.

Some strains of TB have also emerged which are resistant to second choice drugs as well; this is called extensively drug-resistant TB (XDR-TB). There have been outbreaks of XDR-TB in a number of places across the world, often involving people with HIV.

The risk of death from extensively drug-resistant TB is very high. There have been no cases of extensively drug-resistant TB in people with HIV in the UK to date.

HIV & TB

Published June 2008

Last reviewed June 2008

Next review December 2013

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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.