|
Outcome of Tuberculosis in HIV Positive Children
Tuberculosis
(TB) is an important disease in HIV-infected children
living in regions where TB is endemic. There are limited data on
the outcome of culture-confirmed TB in HIV-infected children.
South
African researchers describe the outcome on TB therapy and
overall mortality
in HIV-infected children with culture- confirmed TB through a retrospective
cohort study.
Results
· Eighty-seven
children, median age 24;
· Pulmonary
disease (PTB) was present in 71 episodes (76.3%), extrapulmonary
disease (EPTB) in 43 (46.2%) and of these, both PTB and EPTB were
present in 21 (22.6%);
· There
was cure based on bacteriological and/or radiological criteria in
54 episodes (58.1%).
· Eighteen
children died during TB therapy and there were 34 total deaths (39.1%);
· In univariate analysis (n=87 patients), severe malnutrition,
age </= 1 year and a negative tuberculin skin test were significant
risk factors for death during TB therapy; and
· In
multivariate survival analysis (n=87 patients), HIV disease category,
severe malnutrition at diagnosis and lack of cure at the end of
TB therapy were significantly associated with overall mortality.
Conclusions
Based
on these results, the authors conclude, “In the absence of antiretroviral
therapy, HIV-infected children with confirmed TB have poor outcomes
on anti-tuberculosis therapy and are at high risk of death during
and after completion of anti-tuberculosis therapy, especially due
to non-TB related causes.”
“There
is an urgent need to optimize and monitor anti-tuberculosis therapy
in HIV-infected children and to improve access to TB and other preventative
therapy.”
Stellenbosch University, South Africa.
07/06/05
Reference
A
C Hesseling and others. Outcome of HIV-infected children with
culture-confirmed tuberculosis.
Archives of Disease in Childhood June 17, 2005 [Epub ahead
of print].
|
