Related Experiment Video
Updated: Jul 14, 2026
Processing of Bronchoalveolar Lavage Fluid and Matched Blood for Alveolar Macrophage and CD4+ T-cell Immunophenotyping and HIV Reservoir Assessment
Published on: June 23, 2019
Tuberculosis and human immunodeficiency virus co-infection in children: management challenges
1Department of Paediatrics and Child Health, School of Medicine, University of Zambia, Zambia. cchintu@zamnet.zm
Insights
Childhood HIV and TB co-infection is increasing, posing diagnostic and treatment challenges. Strengthening programs and early intervention are crucial to reduce child morbidity and mortality.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Childhood human immunodeficiency virus (HIV) and tuberculosis (TB) infections mirror adult epidemics, with rising co-infection rates.
- Congenital and neonatal TB incidence is increasing, alongside drug-resistant TB strains in HIV-positive children.
- Co-infection complicates diagnosis due to similar symptoms and non-specific radiological findings, while treatment faces challenges from drug interactions and adherence issues.
Purpose of the Study:
- To highlight the challenges in diagnosing and treating co-infected children.
- To emphasize the need for strengthened childhood TB programs and scaled-up HIV interventions.
- To advocate for increased focus on early diagnosis and treatment of childhood TB.
Main Methods:
- This study is a review of current trends and challenges in childhood HIV and TB co-infection.
- It synthesizes information on diagnostic difficulties, treatment complexities, and drug formulation issues.
- It analyzes the impact of multidrug-resistant and extensively drug-resistant TB in this population.
Main Results:
- Diagnosis of TB in children is difficult and exacerbated by HIV co-infection.
- Treatment is challenging due to drug interactions, adherence problems, and lack of pediatric formulations, leading to unpredictable dosing and potential resistance.
- Existing childhood TB programs require strengthening, alongside scaled-up antiretroviral therapy and mother-to-child transmission prevention.
Conclusions:
- Strengthening childhood TB programs and scaling up HIV interventions are essential to reduce morbidity and mortality.
- Early diagnosis and treatment of TB in children, particularly those with HIV, must be prioritized.
- Isoniazid prophylaxis may be effective in reducing TB morbidity and mortality in HIV-infected children.
Abstract:
The pattern of childhood human immunodeficiency virus (HIV) and tuberculosis (TB) infection mirror these epidemics in the adult population. The number of children co-infected with HIV and TB is rising, and the incidence of congenital and neonatal TB is similarly increasing. In addition, the emergence of multidrug resistant TB and extensively drug-resistant TB has occurred within the context of a high prevalence of HIV and TB. The diagnosis of TB has always been difficult in children and is compounded by HIV co-infection. The clinical symptoms in both diseases are similar, and the radiological changes may be non-specific. Treatment of both conditions in children is a challenge due to drug interactions and problems with adherence. In most developing countries, there are few medicines specifically tested and manufactured for children, with few stable syrup formulations. Thus antituberculosis and antiretroviral tablets have to be divided, giving rise to unpredictable dosing and the possible emergence of resistance. To reduce the morbidity and mortality of TB and HIV, existing childhood TB programmes must be strengthened, and antiretroviral drug therapy and mother-to-child transmission programmes scaled up. An increased emphasis on childhood TB, with early diagnosis and treatment, must be a priority. The provision of isoniazid prophylaxis to HIV-infected children exposed to an adult case of TB or, in areas with a high prevalence of TB, to HIV-infected children (irrespective of a TB contact) may be effective in reducing the morbidity and mortality from childhood TB.
Related Concept Videos
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:25Immunodeficiency Diseases
There are three main causes of immunodeficiency disorders...
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
01:27Cryptococcal Meningitis
01:26Sexually Transmitted Infections
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...