Bacteriologically confirmed tuberculosis in HIV-infected infants: Disease spectrum and survival

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dc.contributor.authorWiseman C.A.
dc.contributor.authorSchaaf H.S.
dc.contributor.authorCotton M.F.
dc.contributor.authorGie R.P.
dc.contributor.authorJennings T.
dc.contributor.authorWhitelaw A.
dc.contributor.authorRoux P.
dc.contributor.authorHesseling A.C.
dc.date.accessioned2011-06-02T13:25:55Z
dc.date.available2011-06-02T13:25:55Z
dc.date.issued2011
dc.description.abstractBACKGROUND: The human immunodeficiency virus (HIV) has resulted in epidemiological shifts with an emergence of tuberculosis (TB) amongst HIV-infected women and infants. There are limited data on the TB disease spectrum and outcome amongst HIV-infected infants. OBJECTIVES: We describe the clinical characteristics, treatment and survival of HIV-infected infants with culture-confirmed TB. METHODS: This retrospective hospital-based study from Cape Town, South Africa, used routine laboratory-based surveillance among infants diagnosed with culture-confirmed TB from 1 January 2004 to 31 December 2006. Folder and chest radiographic review were completed and vitality status established. TB was classified as pulmonary, extra-pulmonary or disseminated disease. RESULTS: Of 52 infants, 37 (71.1%) had pulmonary, 2 (3.9%) extra-pulmonary only, 7 (13.5%) pulmonary and extra-pulmonary and 6 (11.5%) disseminated TB. Forty-six (88.5%) were started anti-tuberculosis therapy; 37 (71.2%) received antiretroviral therapy (ART) and 17 (32.7%) died, 10 (19.2%) of whom never started ART. HIV stage 4 disease was associated with death. TB treatment outcome was poorly documented. CONCLUSIONS: TB is associated with advanced HIV disease and high mortality in HIV-infected infants. Missed opportunities for initiation of ART were frequent. Although the effects of young age, TB disease spectrum and HIV co-infection are difficult to distinguish, our findings support the initiation of early ART in HIV-infected infants with TB. © 2011 The Union.
dc.description.versionArticle
dc.identifier.citationInternational Journal of Tuberculosis and Lung Disease
dc.identifier.citation15
dc.identifier.citation6
dc.identifier.citation770
dc.identifier.citation775+i
dc.identifier.issn10273719
dc.identifier.other10.5588/ijtld.10.0501
dc.identifier.urihttp://hdl.handle.net/10019.1/14837
dc.titleBacteriologically confirmed tuberculosis in HIV-infected infants: Disease spectrum and survival
dc.typeArticle
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