Tuberculosis in HIV-infected children in Europe, Thailand and Brazil: paediatric TB-HIV EuroCoord study.
Int J Tuberc Lung Dis
; 20(11): 1448-1456, 2016 11.
Article
in En
| MEDLINE
| ID: mdl-27776584
ABSTRACT
SETTING:
Centres participating in the Paediatric European Network for Treatment of AIDS (PENTA), including Thailand and Brazil.OBJECTIVE:
To describe the incidence, presentation, treatment and treatment outcomes of tuberculosis (TB) in human immunodeficiency virus (HIV) infected children.DESIGN:
Observational study of TB diagnosed in HIV-infected children in 2011-2013.RESULTS:
Of 4265 children aged <16 years, 127 (3%) were diagnosed with TB 6 (5%) in Western Europe, 80 (63%) in Eastern Europe, 27 (21%) in Thailand and 14 (11%) in Brazil, with estimated TB incidence rates of respectively 239, 982, 1633 and 2551 per 100 000 person-years (py). The majority (94%) had acquired HIV perinatally. The median age at TB diagnosis was 6.8 years (interquartile range 3.0-11.5). Over half (52%) had advanced/severe World Health Organization stage immunodeficiency; 67 (53%) were not on antiretroviral therapy (ART) at TB diagnosis. Preventive anti-tuberculosis treatment was given to 23% (n = 23) of 102 children diagnosed with HIV before TB. Eleven children had unfavourable TBoutcomes:
4 died, 5 did not complete treatment, 1 had recurrent TB and 1 had an unknown outcome. In univariable analysis, previous diagnosis of acquired immune-deficiency syndrome, not being virologically suppressed on ART at TB diagnosis and region (Brazil) were significantly associated with unfavourable TB outcomes.CONCLUSION:
Most TB cases were from countries with high TB prevalence. The majority (91%) had favourable outcomes. Universal ART and TB prophylaxis may reduce missed opportunities for TB prevention.
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Database:
MEDLINE
Main subject:
Tuberculosis
/
HIV Infections
/
Antibiotic Prophylaxis
/
Coinfection
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Country/Region as subject:
America do sul
/
Asia
/
Brasil
/
Europa
Language:
En
Year:
2016
Type:
Article