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

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dc.contributor.authorWalters, Elisabetta
dc.contributor.authorCotton, Mark F.
dc.contributor.authorRabie, Helena
dc.contributor.authorSchaaf, H. Simon
dc.contributor.authorWalters, Lourens O.
dc.contributor.authorMarais, Ben J.
dc.date.accessioned2010-12-13T12:03:36Z
dc.date.available2010-12-13T12:03:36Z
dc.date.issued2008-01
dc.date.updated2010-11-02T19:16:49Z
dc.description.abstractBackground: 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.description.versionPeer Reviewed
dc.format.extent12 p.
dc.identifier.citationWalters, 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.issn1471-2431
dc.identifier.otherhttp://dx.doi.org/10.1186/1471-2431-8-1
dc.identifier.urihttp://hdl.handle.net/10019.1/5067
dc.language.isoen_USen_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.rights.holderWalters et al.; licensee BioMed Central Ltd.en_ZA
dc.subjectHighly active antiretroviral therapy (HAART)en_ZA
dc.subjectTuberculosis in children -- Treatment -- South Africa -- Cape Townen_ZA
dc.subjectHIV infections -- Treatment -- South Africa -- Cape Townen_ZA
dc.subjectHIV positive children -- South Africa -- Cape Townen_ZA
dc.titleClinical presentation and outcome of tuberculosis in human immunodeficiency virus infected children on anti-retroviral therapyen_ZA
dc.typeArticleen_ZA
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