Perinatal tuberculosis and HIV-1: considerations for resource-limited settings

Pandemi infeksi HIV menyebabkan peningkatan pelaporan TB secara bermakna di beberapa negara dengan perkiraan peningkatan insidens TB 20 kali lipat diantara anak yang terinfeksi HIV, dibandingkan dengan anak yang tidak terinfeksi HIV. [1][2][3][4] Hal ini berkaitan dengan keadaan imunokompromais pada infeksi HIV sebagai salah satu faktor risiko penyakit TB, yang mengakibatkan kerusakan sistem imun sehingga kuman TB yang dorman mengalami re-aktivasi. 5TB dan HIV pada anak merupakan penularan dari kasus orang dewasa, dan pola penyakit tersebut mencerminkan epidemi pada populasi orang dewasa. [6][7][8] Pada tahun 1992, diperkirakan oleh Organisasi Kesehatan Dunia bahwa antara 9-11 juta orang dewasa dan 1 juta anak-anak terinfeksi HIV di negara

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“…[10][11][12] Oleh sebab itu HIV/AIDS menjadi ancaman utama terhadap pengendalian TB dan pencapaian MDGs, 13 termasuk Indonesia.…”

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Ko-Infeksi Tuberkulosis dan HIV pada Anak

Widyaningsih

Widhiani

Citraresmi

2016

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“…11 Similarly high MMRs in TB/HIV-co-infected women have been observed in a number of studies in sub-Saharan Africa. 4,[12][13][14] The challenge of TB diagnosis in HIV-infected pregnant women…”

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confidence: 99%

Tuberculosis prevention in HIV-infected pregnant women in South Africa

Martin

Black

2012

South. Afr. j. HIV med.

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The high burden of HIV and tuberculosis (TB) among pregnant women in South Africa contributes to a high maternal mortality rate. Isoniazid preventive therapy (IPT) is recommended for the prevention of active TB in HIV-infected individuals, including pregnant women. However, there are few data regarding IPT use in the latter, with concern regarding the concurrent use of IPT with nevirapine in pregnancy, as both treatments are hepatotoxic. The benefit and safety of IPT in HIV-infected pregnant women has not been established. We recommend a simplification of HIV and TB interventions by providing triple antiretroviral therapy to all HIV-infected pregnant women.

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“…1 Pregnant women with HIV infection have a higher risk of developing active TB than HIV-negative pregnant women. 21,22 TB increases maternal mortality in HIV co-infection.…”

Section: Hiv-tb Co-infection In Pregnancymentioning

confidence: 99%

Tuberculosis and Pregnancy: An Updated Systematic Review

Repossi¹,

Bothamley²

2015

Pulm Res Respir Med Open J

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Tuberculosis (TB) affects women, especially in the child-bearing years. TB is associated with a poorer outcome of pregnancy, although this may be due to the general risk factors for TB, namely poverty, malnutrition and overcrowding. New studies have shown that symptom screening has a low sensitivity and specificity, but is improved by the addition of a tuberculin skin test (TST) or interferon-gamma release assay (IGRA) or, in high incidence areas, DNA amplification tests (e.g. Xpert MTB/RIF). TB-HIV co-infection is a common cause of mortality and morbidity in pregnancy. The diagnostic process remains the same in pregnancy, but non-specific symptoms and extra pulmonary disease demand a higher level of suspicion of TB. Standard first-line treatment is safe in pregnancy. Data on second-line drugs in pregnancy is still limited, but injectable drugs may affect the hearing and balance of the fetus. The IGRA responses appear to change during pregnancy, with more positive responses after delivery. The increasing incidence of drug-resistant TB, especially in Eastern Europe and Central Asia, requires an evaluation of the safety of second-line drugs in pregnancy.

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Perinatal tuberculosis and HIV-1: considerations for resource-limited settings

Cited by 74 publications

References 79 publications

Ko-Infeksi Tuberkulosis dan HIV pada Anak

Ko-Infeksi Tuberkulosis dan HIV pada Anak

Tuberculosis prevention in HIV-infected pregnant women in South Africa

Tuberculosis and Pregnancy: An Updated Systematic Review

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