Clinical presentation and outcome of Tuberculosis in Human Immunodeficiency Virus infected children on anti-retroviral therapy

Walters, Elisabetta; Cotton, Mark F.; Rabie, Helena; Schaaf, H. Simon; Walters, Lourens O; Marais, Ben J.

doi:10.1186/1471-2431-8-1

Cited by 144 publications

(140 citation statements)

References 32 publications

(27 reference statements)

Supporting

Mentioning

121

Contrasting

Order By: Relevance

“…27 The low incidence of serious adverse events related to anti-TB drugs recorded in our study is similar to those from a systematic review, which demonstrated that serious adverse events are usually rare in children living in both resource-constrained and resource-rich countries. 37 Half of the deaths occurred while children were already on ART; the majority within a short time after ART initiation.…”

Section: Discussionsupporting

confidence: 71%

“…31,32 Some experts believe that IPT should be recommended for all HIV-infected children > 1 year of age, even in the absence of documented exposure to an active TB source case. 31 However, findings from a recent 27 However, these classical presentations were less frequently observed in HIV-infected children than in HIV-uninfected children with definite PTB. 33 This could be explained by the relative inability to develop a full inflammatory reaction to TB infection because of HIV-related immunosuppression.…”

Section: Discussionmentioning

confidence: 90%

“…The TB incidence rate was also reduced from 53.3 per 100 person-years during the 9 months pre-ART initiation to 6.4 per 100 person-years during post-ART follow-up period (odds ratio [OR] 16.6; 95% confidence interval [CI] 12.5-22.4). 27 Similarly, Edmonds et al showed a twofold reduction in the number of post-ART TB episodes (32.8% vs. 16.9%) and a reduction of TB incidence rate from 20.4 per 100 person-years in HIV-infected children who did not receive ART to 10.2 per 100 person-years in children who did. 17 The majority of children were at an advanced stage of HIV disease at the time of their PTB diagnoses by both clinical and immunological criteria.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence, Characteristics, Management, and Outcome of Pulmonary Tuberculosis in HIV-Infected Children in the TREAT Asia Pediatric HIV Observational Database (TApHOD)

Sudjaritruk

Maleesatharn

Prasitsuebsai

et al. 2013

AIDS Patient Care and STDs

View full text Add to dashboard Cite

A multicenter, retrospective, observational study was conducted to determine prevalence, characteristics, management, and outcome of pulmonary tuberculosis (PTB) in Asian HIV-infected children in the TREAT Asia Pediatric HIV Observational Database (TApHOD). Data on PTB episodes diagnosed during the period between 12 months before antiretroviral therapy (ART) initiation and December 31, 2009 were extracted. A total of 2678 HIV-infected children were included in TApHOD over a 13-year period; 457 developed PTB, giving a period prevalence of 17.1% (range 5.7-33.0% per country). There were a total of 484 PTB episodes; 27 children had 2 episodes each. There were 21 deaths (4.3%). One third of episodes (n = 175/484) occurred after ART initiation at a median of 14.1 months (interquartile range [IQR] 2.5-28.8 months). The median (IQR) CD4 + values were 9.0% (3.0-16.0%) and 183.5 (37.8-525.0) cells/mm 3 when PTB was diagnosed. Most episodes (n = 424/436, 97.3%) had abnormal radiographic findings compatible with PTB, whereas half (n = 267/484, 55.2%) presented with clinical characteristics of PTB. One third of those tested (n = 42/122, 34.4%) had bacteriological evidence of PTB. Of the 156 episodes (32.2%) that were accompanied with extrapulmonary TB, pleuritis was the most common manifestation (81.4%). After treatment completion, most episodes (n = 396/484, 81.9%) were recorded as having positive outcomes (cured, treatment completed and child well, and improvement). The prevalence of PTB among Asian HIV-infected children in our cohort was high. Children with persistent immunosuppression remain vulnerable to PTB even after ART initiation.

show abstract

Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence, Characteristics, Management, and Outcome of Pulmonary Tuberculosis in HIV-Infected Children in the TREAT Asia Pediatric HIV Observational Database (TApHOD)

Sudjaritruk

Maleesatharn

Prasitsuebsai

et al. 2013

AIDS Patient Care and STDs

View full text Add to dashboard Cite

show abstract

“…TB‐associated immune reconstitution inflammatory syndrome (TB‐IRIS) is not uncommon in children starting ART 171, 172, 173, 174, 175. TB‐IRIS usually develops within 3 months of starting ART, with higher risk in those patients with advanced HIV disease, low pre‐ART CD4 count and shorter interval to starting ART after initiation of TB treatment 175, 176, 177.…”

Section: Coinfectionsmentioning

confidence: 99%

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

et al. 2015

View full text Add to dashboard Cite

The 2015 Paediatric European Network for Treatment of AIDS (PENTA) guidelines provide practical recommendations on the management of HIV‐1 infection in children in Europe and are an update to those published in 2009. Aims of treatment have progressed significantly over the last decade, moving far beyond limitation of short‐term morbidity and mortality to optimizing health status for adult life and minimizing the impact of chronic HIV infection on immune system development and health in general. Additionally, there is a greater need for increased awareness and minimization of long‐term drug toxicity. The main updates to the previous guidelines include: an increase in the number of indications for antiretroviral therapy (ART) at all ages (higher CD4 thresholds for consideration of ART initiation and additional clinical indications), revised guidance on first‐ and second‐line ART recommendations, including more recently available drug classes, expanded guidance on management of coinfections (including tuberculosis, hepatitis B and hepatitis C) and additional emphasis on the needs of adolescents as they approach transition to adult services. There is a new section on the current ART ‘pipeline’ of drug development, a comprehensive summary table of currently recommended ART with dosing recommendations. Differences between PENTA and current US and World Health Organization guidelines are highlighted and explained.

show abstract

“…The incidence of TB disease is estimated at 23/100 child-years in HIVinfected children in SA. [26] Access to ART remains an essential intervention to prevent TB, and in children on therapy rates have declined substantially.…”

Section: Once-daily Dosingmentioning

confidence: 99%

Antiretroviral therapy for the management of HIV in children

2014

View full text Add to dashboard Cite

Guidance on the indications for starting antiretroviral therapy (ART) and the preferred initial drugs has evolved substantially over the past 15 years. These changes were the result of a better understanding of the rate of disease progression and the high early morbidity and mortality. There is now a better appreciation of the long-term implications of early therapy and how to sequence the available drugs.

show abstract

Clinical presentation and outcome of Tuberculosis in Human Immunodeficiency Virus infected children on anti-retroviral therapy

Cited by 144 publications

References 32 publications

Prevalence, Characteristics, Management, and Outcome of Pulmonary Tuberculosis in HIV-Infected Children in the TREAT Asia Pediatric HIV Observational Database (TApHOD)

Prevalence, Characteristics, Management, and Outcome of Pulmonary Tuberculosis in HIV-Infected Children in the TREAT Asia Pediatric HIV Observational Database (TApHOD)

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

Antiretroviral therapy for the management of HIV in children

Contact Info

Product

Resources

About