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Incident tuberculosis and risk factors among HIV-infected children in Tanzania

Nan Li1, Karim P Manji, Donna Spiegelman

  • 1Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, USA.

AIDS (London, England)
|January 25, 2013
PubMed

Insights

Antiretroviral therapy significantly reduces tuberculosis risk in HIV-infected children. Interventions targeting nutritional and hematologic status are also recommended for pediatric TB prevention.

Area of Science:

  • Pediatric infectious diseases
  • HIV/AIDS research
  • Tuberculosis epidemiology

Background:

  • Pediatric tuberculosis (TB) poses a significant health burden, particularly in populations co-infected with human immunodeficiency virus (HIV).
  • Understanding risk factors for TB in HIV-infected children is crucial for effective prevention and management strategies.

Purpose of the Study:

  • To determine the incidence of pediatric TB within an HIV-infected cohort.
  • To identify demographic and clinical factors associated with the development of TB in these children.

Main Methods:

  • A longitudinal analysis was conducted on a cohort of 5040 HIV-infected children under 15 years old.
  • Cox proportional hazard regression models were used to identify predictors of incident TB.
  • Data included clinical diagnoses of TB, demographic information, nutritional status, immune suppression, anemia, and antiretroviral drug use.

Main Results:

  • The overall incidence of TB was 5.2 per 100 person-years.
  • Older age, severe wasting, severe immune suppression, anemia, and WHO stage IV were independently associated with increased TB risk.
  • Antiretroviral therapy (ART) use for over 180 days was associated with a 70% reduction in TB risk.

Conclusions:

  • Antiretroviral therapy (ART) is a key intervention for reducing TB incidence in HIV-infected children.
  • Integrated HIV care and treatment programs should include TB prevention strategies.
  • Further research and trials focusing on improving nutritional and hematologic status in this population are warranted.
Abstract

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