Presentation, diagnosis and management of tuberculosis in HIV-infected children in the UK
- PMID: 18331563
- DOI: 10.1111/j.1468-1293.2008.00559.x
Presentation, diagnosis and management of tuberculosis in HIV-infected children in the UK
Abstract
Objectives: Management of HIV-infected children with tuberculosis (TB) is challenging. The objective of this study was to assess current treatment and outcomes in a resource-rich setting in the era of highly active antiretroviral therapy (HAART).
Methods: A retrospective case-note review of coinfected children was carried out in a large UK-based HIV family clinic.
Results: Of 328 HIV-infected children, 18 were diagnosed and treated for active TB. TB presentation led to HIV diagnosis in eight of these 18 children. TB was confirmed microbiologically in 33% of children. Fifteen of the 18 children presented with pulmonary TB, and three with extrapulmonary TB (EPTB). Immunological status at TB diagnosis did not predict EPTB. The mean CD4 T-cell count at TB presentation was 402 cells/microL (mean CD4 percentage 16%), with a range of 0-790 cells/microL (0-34%). In seven children concurrently treated with HAART and anti-tuberculous therapy (ATT), therapeutic drug monitoring (TDM) guided management. No immune reconstitution disease occurred. There was one death, unrelated to TB, 2 years after completion of ATT.
Conclusions: An HIV test should be considered in all children diagnosed with TB, especially if there are epidemiological risk factors. Our experience shows that, even with deferral of HAART in concurrently infected children, good therapeutic responses to ATT can be achieved. Where necessary, TDM guiding concurrent HAART and ATT can facilitate good clinical and virological responses.
Similar articles
-
Clinical correlate of tuberculosis in HIV co-infected children at the University of Abuja Teaching Hospital, Gwagwalada, Nigeria.Niger J Clin Pract. 2011 Apr-Jun;14(2):206-11. doi: 10.4103/1119-3077.84018. Niger J Clin Pract. 2011. PMID: 21860141
-
Current issues in the diagnosis and management of tuberculosis and HIV coinfection in the United States.Top HIV Med. 2010 Oct-Nov;18(4):143-8. Top HIV Med. 2010. PMID: 21107014 Review.
-
Development of opportunistic infections after diagnosis of active tuberculosis in HIV-infected patients.AIDS Patient Care STDS. 2004 Jun;18(6):341-7. doi: 10.1089/1087291041444069. AIDS Patient Care STDS. 2004. PMID: 15294084
-
Tuberculosis in HIV-infected patients: a comprehensive review.Clin Microbiol Infect. 2004 May;10(5):388-98. doi: 10.1111/j.1469-0691.2004.00758.x. Clin Microbiol Infect. 2004. PMID: 15113314 Review.
-
Improved outcomes of HIV-1-infected adults with tuberculosis in the era of highly active antiretroviral therapy.AIDS. 2003 Dec 5;17(18):2615-22. doi: 10.1097/00002030-200312050-00008. AIDS. 2003. PMID: 14685055
Cited by
-
Unmet basic needs negatively affect health-related quality of life in people aging with HIV: results from the Positive Spaces, Healthy Places study.BMC Public Health. 2018 May 21;18(1):644. doi: 10.1186/s12889-018-5391-z. BMC Public Health. 2018. PMID: 29783965 Free PMC article.
-
Tuberculosis and pneumonia in HIV-infected children: an overview.Pneumonia (Nathan). 2016 Nov 24;8:19. doi: 10.1186/s41479-016-0021-y. eCollection 2016. Pneumonia (Nathan). 2016. PMID: 28702298 Free PMC article. Review.
-
Getting to 90-90-90 in paediatric HIV: What is needed?J Int AIDS Soc. 2015 Dec 2;18(7Suppl 6):20770. doi: 10.7448/IAS.18.7.20770. eCollection 2015. J Int AIDS Soc. 2015. PMID: 28326130 Free PMC article. No abstract available.
-
Pediatric tuberculosis-human immunodeficiency virus co-infection in the United Kingdom highlights the need for better therapy monitoring tools: a case report.J Med Case Rep. 2017 Feb 26;11(1):52. doi: 10.1186/s13256-017-1222-6. J Med Case Rep. 2017. PMID: 28236807 Free PMC article.
-
Profiles of HIV-infected anti-retroviral therapy naïve children from Mumbai, India.World J Pediatr. 2016 Nov;12(4):430-435. doi: 10.1007/s12519-016-0035-9. Epub 2016 Jun 10. World J Pediatr. 2016. PMID: 27286695
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Research Materials