Tuberculosis among Children and Adolescents at HIV Treatment Centers in Sub-Saharan Africa

Autor: Angelina Kayabu, Alexander W. Kay, Moorine Penninah Sekadde, Andrew R. DiNardo, Sandile Dlamini, David Damba, Makhorong Matsoso, Mogo Matshaba, Richard S. Wanless, Rachel Golin, Lineo Thahane, Tara Devezin, Joseph Mhango, Saeed Ahmed, Bhekumusa Lukhele, Dilsher Dhillon, Katherine R Simon, Moses Chodota, Pauline Amuge, Jill Sanders, Gordon E. Schutze, Anna M. Mandalakas, Neway G Fida, Nodumo Chidah, Jason M. Bacha
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Pediatrics
Malawi
medicine.medical_treatment
Human immunodeficiency virus (HIV)
lcsh:Medicine
HIV Infections
medicine.disease_cause
Tanzania
Epidemiology
Uganda
adolescents
Child
bacteria
Botswana
biology
Incidence (epidemiology)
Immunosuppression
Lesotho
Infectious Diseases
tuberculosis
epidemiology
Microbiology (medical)
Adult
medicine.medical_specialty
Tuberculosis
Tuberculosis among Children and Adolescents at HIV Treatment Centers in Sub-Saharan Africa
Adolescent
antiretroviral therapy
lcsh:Infectious and parasitic diseases
Mycobacterium tuberculosis
respiratory infections
children
medicine
Humans
viruses
lcsh:RC109-216
HIV/AIDS and other retroviruses
Africa South of the Sahara
business.industry
Research
lcsh:R
HIV
medicine.disease
biology.organism_classification
Antiretroviral therapy
tuberculosis and other mycobacteria
business
Eswatini
Zdroj: Emerging Infectious Diseases, Vol 26, Iss 12, Pp 2933-2943 (2020)
Emerging Infectious Diseases
ISSN: 1080-6059
1080-6040
Popis: HIV-infected children and adolescents are at increased risk for tuberculosis (TB). Antiretroviral therapy (ART) reduces TB risk in HIV-infected adults, but its effectiveness in HIV-infected children and adolescents is unknown. We analyzed data from 7 integrated pediatric HIV/TB centers in 6 countries in sub-Saharan Africa. We used a Bayesian mixed-effect model to assess association between ART and TB prevalence and used adaptive lasso regression to analyze risk factors for adverse TB outcomes. The study period encompassed 57,525 patient-years and 1,160 TB cases (2,017 cases/100,000 patient-years). Every 10% increase in ART uptake resulted in a 2.33% reduction in TB prevalence. Favorable TB outcomes were associated with increased time in care and early ART initiation, whereas severe immunosuppression was associated with death. These findings support integrated HIV/TB services for HIV-infected children and adults and demonstrate the association of ART uptake with decreased TB incidence in high HIV/TB settings.
Databáze: OpenAIRE
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