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Antiretroviral Therapy in HIV-Infected Children With Tuberculosis: A Systematic Review

Giorgia Sulis1, Silvia Amadasi1, Anna Odone2

  • 1From the University Department of Infectious and Tropical Diseases, WHO Collaborating Centre for TB/HIV co-infection and for TB elimination, University of Brescia, Brescia, Italy.

The Pediatric Infectious Disease Journal
|September 14, 2017
PubMed

Insights

Limited evidence exists for treating tuberculosis (TB) in children with HIV. More research is crucial to improve outcomes for these coinfected children and reach global health targets.

Area of Science:

  • Pediatric Infectious Diseases
  • Global Health

Background:

  • Tuberculosis (TB) is a leading cause of death in children with HIV globally.
  • Current treatment guidelines for antiretroviral therapy in children with TB lack robust evidence due to limited nonrandomized studies.
  • There is a critical need for evidence-based management strategies for HIV-TB coinfection in pediatric populations.

Purpose of the Study:

  • To systematically review and critically appraise the available evidence on the efficacy and safety of different antiretroviral regimens in children coinfected with HIV and TB.
  • To identify optimal treatment options for children with HIV and active TB.

Main Methods:

  • Conducted a systematic literature review following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
  • Searched Medline, Embase, and key conference proceedings up to March 2016.
  • Selected six observational studies for qualitative synthesis; meta-analysis was not feasible.

Main Results:

  • The evidence base for managing HIV/TB coinfected children is limited.
  • Six observational studies were included in the qualitative synthesis.
  • Meta-analysis could not be performed due to the nature of the retrieved studies.

Conclusions:

  • Optimal treatment strategies for children with HIV and TB coinfection are not well-established.
  • Further research is essential to include coinfected children in treatment studies and address this neglected area.
  • Ensuring coinfected children are part of key treatment studies is vital for achieving global HIV and TB elimination goals.
Abstract

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