In a large retrospective study, Weltman and Rose1 found that the vast majority of multidrug-resistant (MDR) tuberculosis (TB) cases observed at a New York City hospital in the years 1991 and 1992 were diagnosed in patients with acquired immunodeficiency syndrome (AIDS). Prior episodes of nosocomial transmission of MDR TB, in which some of the patients investigated were involved, may well account for the association between AIDS and MDR TB that they described.2,3 The latter may thus be interpreted as a temporal and spatial clustering of subjects that belong to a group that is at high risk for TB. On the basis of the current literature on MDR TB, however, it seems that the association between MDR strains of Mycobacterium tuberculosis and subjects with human immunodeficiency virus (HIV) infection goes beyond both the recognized vulnerability of these patients to TB and some circumstantial episodes of exposure to such resistant
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