HIV-associated pediatric tuberculosis: prevention, diagnosis and treatment

Alexander Kay1,2, Anthony J Garcia-Prats3, Anna Maria Mandalakas1

  • 1The Global TB Program, Texas Children's Hospital and the Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.

Insights

Tuberculosis (TB) is a major cause of death in children living with HIV (CALWH). New diagnostic tools and treatments are emerging to combat this challenge and improve outcomes for this vulnerable group.

Area of Science:

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

Background:

  • HIV and TB epidemics create a devastating synergy, disproportionately affecting children.
  • Children living with HIV (CALWH) face unique challenges in TB prevention and diagnosis.

Purpose of the Study:

  • To review the current challenges and recent advancements in combating tuberculosis in children living with HIV.
  • To highlight the need for accelerated research and evidence-based strategies for TB prevention, diagnosis, and treatment in CALWH.

Main Methods:

  • Review of recent data and research findings on TB in CALWH.
  • Analysis of current diagnostic tools, preventive therapies, and treatment complications.

Main Results:

  • CALWH benefit less from BCG vaccination and often do not receive recommended TB preventive therapy.
  • Diagnostic tool utility is reduced in CALWH, and drug interactions complicate co-treatment.
  • Emerging diagnostic approaches (e.g., stool-based) and improved drug formulations show promise.

Conclusions:

  • TB is the leading cause of mortality among CALWH, necessitating urgent research and intervention.
  • Adopting evidence-based preventive and treatment strategies is crucial to improve outcomes for CALWH.
  • Renewed commitment to TB prevention and control in this vulnerable population is essential.
Abstract

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