Recurrent culture-confirmed tuberculosis in human immunodeficiency virus-infected children
Date
2005
Authors
Schaaf H.S.
Krook S.
Hollemans D.W.
Warren R.M.
Donald P.R.
Hesseling A.C.
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Abstract
Introduction: Recurrent tuberculosis (TB) is more common among human immunodeficiency virus (HIV)-infected than HIV-uninfected adults. There are limited data regarding recurrence of TB in children. Objective: To determine the occurrence of recurrent TB in HIV-infected children with culture-confirmed tuberculosis. Methods: HIV-infected children with culture-confirmed TB, identified from 1992 to 2000, were followed until February 2004 for further confirmed TB episodes 6 months or more after completion of previous antituberculosis therapy. Clinical data and results of special investigations were recorded. Restriction fragment length polymorphism (RFLP) analysis of Mycobacterium tuberculosis isolates was done when possible. Results: Of 87 children, 9 had a second episode; 2 of these had a third episode of confirmed TB. Adherence to treatment was good in 8; 2 experienced hepatotoxicity, and regimens were changed. Chest radiographs were normal in only 2 children after first treatment completion. Bacteriologic cure was documented in 7 episodes before recurrence. RFLP analysis showed 3 children infected with the same strain (relapse) and 1 child with a different strain between episodes 1 and 3 (reinfection). Two further cases had reinfection based on epidemiologic data and drug susceptibility test results. Full comparison of strains by RFLP was not possible because of the unavailability of isolates of the first episode in 5 cases. Conclusion: Recurrent TB in HIV-infected children is common in a high burden TB setting. Both relapse and reinfection occur. Copyright © 2005 by Lippincott Williams & Wilkins.
Description
Keywords
antiretrovirus agent, ethambutol, ethionamide, isoniazid, ofloxacin, pyrazinamide, rifampicin, streptomycin, tuberculostatic agent, article, bacterium culture, bacterium isolate, bronchiectasis, child, childhood disease, computer assisted tomography, controlled study, drug sensitivity, enzyme linked immunosorbent assay, extrapulmonary tuberculosis, female, follow up, highly active antiretroviral therapy, human, Human immunodeficiency virus infection, infant, liver toxicity, lung tuberculosis, lymphadenopathy, major clinical study, male, mediastinum lymph node, miliary tuberculosis, Mycobacterium tuberculosis, patient compliance, pericardial effusion, pleura effusion, polymerase chain reaction, priority journal, recurrent infection, reinfection, relapse, restriction fragment length polymorphism, retrospective study, risk factor, short course therapy, South Africa, thorax radiography, thrombocytopenia, tuberculin test, tuberculosis, tuberculous meningitis, Child, Child, Preschool, Female, HIV Infections, Humans, Male, Recurrence, Retrospective Studies, Risk Factors, South Africa, Tuberculosis
Citation
Pediatric Infectious Disease Journal
24
8
24
8