Clinical presentation and outcome of tuberculosis in human immunodeficiency virus infected children on anti-retroviral therapy

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dc.contributor.author Walters, Elisabetta
dc.contributor.author Cotton, Mark F.
dc.contributor.author Rabie, Helena
dc.contributor.author Schaaf, H. Simon
dc.contributor.author Walters, Lourens O.
dc.contributor.author Marais, Ben J.
dc.date.accessioned 2010-12-13T12:03:36Z
dc.date.available 2010-12-13T12:03:36Z
dc.date.issued 2008-01
dc.identifier.citation Walters, E, Cotton, MF, Rabie, H, Schaaf, HS, Walters, LO, & Marais, BJ 2008, 'Clinical presentation and outcome of Tuberculosis in Human Immunodeficiency Virus infected children on anti-retroviral therapy', BMC Pediatrics, 8(1):1. en_ZA
dc.identifier.issn 1471-2431
dc.identifier.other http://dx.doi.org/10.1186/1471-2431-8-1
dc.identifier.uri http://hdl.handle.net/10019.1/5067
dc.description.abstract 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. en_ZA
dc.format.extent 12 p.
dc.language.iso en_US en_ZA
dc.publisher BioMed Central en_ZA
dc.subject Highly active antiretroviral treatment (HAART) en_ZA
dc.subject Tuberculosis in children -- Treatment -- South Africa -- Cape Town en_ZA
dc.subject HIV infection -- Treatment -- South Africa -- Cape Town en_ZA
dc.subject HIV positive children -- South Africa -- Cape Town en_ZA
dc.title Clinical presentation and outcome of tuberculosis in human immunodeficiency virus infected children on anti-retroviral therapy en_ZA
dc.type Article en_ZA
dc.date.updated 2010-11-02T19:16:49Z
dc.description.version Peer Reviewed
dc.language.rfc3066 en
dc.rights.holder Walters et al.; licensee BioMed Central Ltd. en_ZA


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