Prevalence, incidence, and associated risk factors of tuberculosis in children with HIV living in the UK and Ireland (CHIPS): a cohort study

Turkova, Anna; Chappell, Elizabeth; Judd, Ali; Goodall, Ruth; Welch, S; Foster, Caroline; Riordan, Andrew; Shingadia, Delane; Shackley, Fiona; Doerholt, Katja; Gibb, Diana M; Collins, Intira Jeannie

doi:10.1016/s2352-3018(15)00200-3

Cited by 17 publications

(14 citation statements)

References 30 publications

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“…This study showed that the incidence of TB was higher among WHO clinical stages 3 and 4 compared to 1 and 2. This finding was in agreement with those of studies done in Tanzania [24], China [20], UK, and Ireland [32]. The declining of immunity in advanced WHO clinical stages accelerates the progression of latent TB infection to active TB infection so that children presenting with advanced WHO clinical stages need to have close monitoring.…”

Section: Discussionsupporting

confidence: 91%

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Incidence of tuberculosis in children on antiretroviral therapy: a retrospective cohort study

2018

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ObjectivesBe aware of the burden of tuberculosis among high-risk population is important. Three hundred fifty-two children were participated in this study. Survival analysis was conducted. We assessed the incidence of tuberculosis and its predictors in children on ART.ResultsTuberculosis incidence rate in children on ART was 2.63 per 100 person-years. Those children who were on baseline World Health Organization clinical stages 3 and 4 (AHR (adjusted hazard ratio) = 3.0; 95% CI 1.2–7.7), “fair” and “poor” ART adherence (AHR = 4.0; 95% CI 1.5–10.8), late initiation of ART (AHR = 4.0; 95% CI 1.5–10.6), and less than 6 months duration on ART (AHR = 5.5; 95% CI 1.5–20.6) were more likely to develop tuberculosis infection. The incidence rate of TB in children on ART was high. This study suggests a need to give attention to advanced AIDS stages and improve timely initiation of ART and level of adherence to ART.

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Section: Discussionsupporting

confidence: 91%

“…On the other hand, TB incidence rate of this study was higher than that of a study conducted in Latin America [16], UK and Ireland [32], and China [20]. This variation might be due to the fact that the incidence rate of TB was low in the general population of high-income countries.…”

Section: Discussioncontrasting

confidence: 74%

Incidence of tuberculosis in children on antiretroviral therapy: a retrospective cohort study

2018

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“…Even with cART, comorbidity incidence (including tuberculosis, childhood infections and malignancies) is higher in HIV-infected than uninfected children [87,88,89,90,91]; infections still predominate as causes of death [21,22,92,93]. AIDS-defining infections have declined, but non-AIDS defining conditions (sepsis; pneumonia) remain relatively stable [21,22,92,93,94].…”

Section: Comorbidities That Reduce Survival In Hiv-infected Childrenmentioning

confidence: 99%

Survival of HIV-1 vertically infected children

Davies

Gibb

Turkova

2016

Current Opinion in HIV and AIDS

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Purpose of review It is 20 years since the start of the combination antiretroviral therapy (cART) era and >10 years since cART scale-up began in resource-limited settings. We examined survival of vertically HIV-infected infants and children in the cART era. Recent findings Good survival has been achieved on cART in all settings with up to ten-fold mortality reductions compared to before cART availability. Although mortality risk remains high in the first few months after cART initiation in young children with severe disease, it drops rapidly thereafter even for those who started with advanced disease, and longer term mortality risk is low. However, suboptimal retention on cART in routine programs threatens good survival outcomes and even on treatment children continue to experience high comorbidity risk; infections remain the major cause of death. Interventions to address infection risk include co-trimoxazole prophylaxis, isoniazid preventive therapy, routine childhood and influenza immunization and improving maternal survival. Summary Pediatric survival has improved substantially with cART and HIV-infected children are aging into adulthood. It is important to ensure access to diagnosis and early cART, good program retention and optimal co-morbidity prophylaxis and treatment to achieve the best possible long-term survival and health outcomes for vertically infected children.

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“…With paediatric HIV cases also increasing globally, the burden to prevent the disease is increasing 9. The patient was tested for HIV to check for any association but test result was negative.…”

Section: Discussionmentioning

confidence: 99%

Primary tuberculous osteomyelitis of the mandible in a 3-year-old child

et al. 2016

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A 3-year-old girl child presented with swelling in her right lower jaw that had started 5 days previously. History revealed the child being non-immunised. Initial-evaluation revealed proptosis and bony hard swelling over the right body of the mandible. Radiological evaluation including a CT scan indicated expansile osteolytic lesion involving the body-ramus with onion-peel periosteal reaction suggesting osteomyelitis/malignancy. Blood investigations showed raised erythrocyte sedimentation rate and eosinophilia. Family screening for tuberculosis (TB) revealed that the patient, her father and siblings were PPD positive though chest screening and sputum examinations were negative in all of them. Lesion biopsy showed acute/chronic osteomyelitis with eosinophilia, tilting diagnosis towards eosinophilic granuloma/Hand-Schuller-Christian disease. Further investigations for diabetes insipidus, histiocytosis-X, skull-pelvic-femur radiographs, abdominal ultrasonography, ophthalmic consultation and PCR-TB test were negative. Histology, radiography, purified protein derivative (PPD)-positive result and history led to the diagnosis of primary TB of the mandible. Complete resolution occurred following antitubercular therapy. The case report emphasises that diagnosis of TB can sometimes be based on circumstantial evidence and positive response to antitubercular therapy even in view of a negative PCR result.

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Prevalence, incidence, and associated risk factors of tuberculosis in children with HIV living in the UK and Ireland (CHIPS): a cohort study

Abstract: NHS England, PENTA Foundation.

Cited by 17 publications

References 30 publications

Incidence of tuberculosis in children on antiretroviral therapy: a retrospective cohort study

Incidence of tuberculosis in children on antiretroviral therapy: a retrospective cohort study

Survival of HIV-1 vertically infected children

Primary tuberculous osteomyelitis of the mandible in a 3-year-old child

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