PMID- 18186944
OWN - NLM
STAT- MEDLINE
DCOM- 20080304
LR  - 20220318
IS  - 1471-2431 (Electronic)
IS  - 1471-2431 (Linking)
VI  - 8
DP  - 2008 Jan 11
TI  - Clinical presentation and outcome of tuberculosis in human immunodeficiency virus 
      infected children on anti-retroviral therapy.
PG  - 1
LID - 10.1186/1471-2431-8-1 [doi]
AB  - BACKGROUND: The tuberculosis (TB) and human immunodeficiency virus (HIV) 
      epidemics are poorly controlled in sub-Saharan Africa, where highly active 
      antiretroviral treatment (HAART) has become more freely available. Little is 
      known about the clinical presentation and outcome of TB in HIV-infected children 
      on HAART. METHODS: We performed a comprehensive file review of all children who 
      commenced HAART at Tygerberg Children's Hospital from January 2003 through 
      December 2005. RESULTS: Data from 290 children were analyzed; 137 TB episodes 
      were recorded in 136 children; 116 episodes occurred before and 21 after HAART 
      initiation; 10 episodes were probably related to immune reconstitution 
      inflammatory syndrome (IRIS). The number of TB cases per 100 patient years were 
      53.3 during the 9 months prior to HAART initiation, and 6.4 during post HAART 
      follow-up [odds ratio (OR) 16.6; 95% confidence interval (CI) 12.5-22.4]. A 
      positive outcome was achieved in 97/137 (71%) episodes, 6 (4%) cases experienced 
      no improvement, 16 (12%) died and the outcome could not be established in 18 
      (13%). Mortality was less in children on HAART (1/21; 4.8%) compared to those not 
      on HAART (15/116; 12.9%). CONCLUSION: We recorded an extremely high incidence of 
      TB among HIV-infected children, especially prior to HAART initiation. Starting 
      HAART at an earlier stage is likely to reduce morbidity and mortality related to 
      TB, particularly in TB-endemic areas. Management frequently deviated from 
      standard guidelines, but outcomes in general were good.
FAU - Walters, Elisabetta
AU  - Walters E
AD  - Department of Pediatrics and Child Health, Faculty of Health Sciences, 
      Stellenbosch University, Cape Town, South Africa. walters@tiscali.co.za
FAU - Cotton, Mark F
AU  - Cotton MF
FAU - Rabie, Helena
AU  - Rabie H
FAU - Schaaf, H Simon
AU  - Schaaf HS
FAU - Walters, Lourens O
AU  - Walters LO
FAU - Marais, Ben J
AU  - Marais BJ
LA  - eng
PT  - Journal Article
DEP - 20080111
PL  - England
TA  - BMC Pediatr
JT  - BMC pediatrics
JID - 100967804
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - *Antiretroviral Therapy, Highly Active/adverse effects
MH  - Antitubercular Agents/adverse effects/therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Comorbidity
MH  - Endemic Diseases
MH  - Female
MH  - HIV Infections/drug therapy/*epidemiology
MH  - Humans
MH  - Incidence
MH  - Infant
MH  - Male
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Tuberculosis, Pulmonary/diagnosis/drug therapy/*epidemiology
PMC - PMC2246130
EDAT- 2008/01/12 09:00
MHDA- 2008/03/05 09:00
PMCR- 2008/01/11
CRDT- 2008/01/12 09:00
PHST- 2007/08/08 00:00 [received]
PHST- 2008/01/11 00:00 [accepted]
PHST- 2008/01/12 09:00 [pubmed]
PHST- 2008/03/05 09:00 [medline]
PHST- 2008/01/12 09:00 [entrez]
PHST- 2008/01/11 00:00 [pmc-release]
AID - 1471-2431-8-1 [pii]
AID - 10.1186/1471-2431-8-1 [doi]
PST - epublish
SO  - BMC Pediatr. 2008 Jan 11;8:1. doi: 10.1186/1471-2431-8-1.