Outcome of HIV infected children with culture confirmed tuberculosis
| Autor: | H Werschkull, Peter R. Donald, Nulda Beyers, G. Hussey, Anneke C. Hesseling, W El-Sadr, A E Westra, H Simon Schaaf |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
Tuberculosis Adolescent Endemic Diseases Antitubercular Agents Tuberculin Disease South Africa Acquired immunodeficiency syndrome (AIDS) Internal medicine Humans Medicine Child Sida Tuberculosis Pulmonary Retrospective Studies Univariate analysis AIDS-Related Opportunistic Infections biology business.industry Malnutrition virus diseases Infant Retrospective cohort study medicine.disease biology.organism_classification Survival Analysis Surgery Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Original Article Viral disease business |
| Zdroj: | Archives of Disease in Childhood. 90:1171-1174 |
| ISSN: | 1468-2044 0003-9888 |
| DOI: | 10.1136/adc.2004.070466 |
| Popis: | Background: Tuberculosis (TB) is an important disease in human immunodeficiency virus (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. Aims and Methods: To 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 months, contributed to 93 TB episodes; six children had two confirmed episodes. 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 a total of 34 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. 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. Conclusion: In the absence of antiretroviral therapy, HIV infected children with confirmed TB have poor outcomes on antituberculosis therapy and are at high risk of death during and after completion of antituberculosis therapy, especially due to non-TB related causes. There is an urgent need to optimise and monitor antituberculosis therapy in HIV infected children and to improve access to TB and other preventative therapy. |
| Databáze: | OpenAIRE |
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