Tuberculosis in a Spanish cohort of children living with HIV: the CHOTIS study (Childhood HIV & TB study)
| Autor: | J.T. Ramos Amador, Marie Antoinette Frick, M. Bustillo Alonso, S Jiménez de Ory, Jorge Martínez-Pérez, Falcón Neyra, E Colino Gil, T Vallmanya Cucurull, B Santiago-García, M Méndez Hernández, M L Navarro Gómez, Talía Sainz, María Isabel González-Tomé, P Collado Hernández, M J Mellado-Peña, C. Guerrero Laleona, A G Andrés Andrés, E M López-Medina |
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| Přispěvatelé: | Cohorte Nacional de Pacientes Pediátricos con Infección VIH (España), Red Española de Investigación en SIDA, Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo (España), European Commission |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Pediatrics Tuberculosis Adolescent HIV Infections cART Immigration Cohort Studies Tuberculosis diagnosis Epidemiology Medicine Humans Child Retrospective Studies business.industry Coinfection Incidence (epidemiology) HIV Retrospective cohort study medicine.disease Co-infection Infectious Diseases Spain Cohort business Cohort study |
| Zdroj: | Digital.CSIC. Repositorio Institucional del CSIC instname |
| Popis: | National Network of HIV-infected Children (CORISPE); National Pediatric TB Network (pTBred) of Spain; Translational Research Network in Pediatric Infectious Diseases (RITIP). [Background] Tuberculosis (TB) is the leading opportunistic infection in children with human immunodeficiency virus (HIV), but is uncommon in low prevalence regions. We aim to describe the changing epidemiology and clinical presentation of TB-HIV co-infection in a cohort of HIV-infected children in Spain. [Methods] Children diagnosed with TB between 1995 and 2016 in the paediatric HIV cohort were identified. The incidence and clinical presentation were compared in three periods: 1995–1999 (P1, before initiation of combined antiretroviral therapy, cART), 2000–2009 (P2, increase in immigration), and 2010–2016 (P3, decrease in immigration). [Results] We included 29 TB cases among 1183 children aged 10 years (20% vs. 23.1% vs. 83.3%, P = 0.01). TB was diagnosed at HIV presentation in 11/29 children (37.9%). Foreign-born children accounted for respectively 0%, 8% and 67% of the total number of children in each period (P ≤ 0.0001). One third had extrapulmonary TB; four children died (13.8%). [Conclusion] In our cohort, the incidence of TB-HIV co-infection decreased with decline in immigration. In regions with adequate cART coverage and low TB transmission, paediatric TB-HIV coinfection is uncommon, but associated with significant morbidity. Strategies for TB surveillance, diagnosis and treatment in this vulnerable population should be reinforced. This study was supported by the Spanish National Pediatric Network for HIV infected Children and Adolescents (CoRISpe) integrated in the Spanish AIDS Research Network (RIS), and supported by Instituto de Salud Carlos III, Spanish Health Ministry [Grant n8 RD16/0025/0024 and RD06/0025] as part of the Plan RþDþI; and co-financed by ISCIII-Subdirecci ´on General de Evaluaci ´on and Fondo Europeo de Desarrollo Regional (FEDER ‘‘Una manera de hacer Europa’’), RIS-EPICLIN-18/2015. TS and BS are funded by Spanish Ministry of Health - Instituto de Salud Carlos III (ISCIII) and co-funded by the European Union (FEDER) [Contratos Juan Rod´es, Grant JR16/00021 (TS) and JR16/00036 (BSG)]. |
| Databáze: | OpenAIRE |
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