Drug resistance and HIV rates are high in Eastern European patients with Tuberculosis in a South East London Hospital

<b>Introduction:</b> Although Europe represents only 3% of the global burden of tuberculosis (TB), globally it has one of the highest proportions of multidrug-resistant TB (MDRTB). TB infection in Eastern Europe remains one of the key drivers of this epidemic. We investigated the Eastern European/Balkan TB population in our South East (SE) London Hospital. <b>Method:</b> Retrospective cohort analysis of Eastern European/Balkan nations in SE London 2008 - 2018. Data was collected from clinical records and the London TB Register. <b>Results:</b> 44 Eastern European/Balkan TB cases were identified from 1081. 70% were male; median age 35. The proportion of patients with pulmonary TB was high, 82%.11% had previous diagnosis of TB. Of those HIV tested, 10% were positive cf. Europe-wide rates of 4.5%. 6.4% had isoniazid resistance (INH-R); 3.2% MDRTB; 3.2% extremely drug resistant TB (XDRTB). Completion of treatment was confirmed in 84%; 11% transferring care. <b>Conclusion:</b> Young, male Eastern Europeans form a significant proportion of pulmonary INH-R/MDRTB/XDRTB, with high HIV and transfer of care rates. This may be representative of a working migrant population with a high risk of both initial and acquired TB resistance. Whole genome sequencing would help define this group further.