Tuberculosis in Children Living With HIV: Ongoing Progress and Challenges

Area of Science:

• Pediatric Infectious Diseases
• Global Public Health
• HIV/TB Co-epidemiology

Background:

• Tuberculosis (TB) and human immunodeficiency virus (HIV) coinfection significantly impacts pediatric mortality worldwide.
• Progress in managing TB-HIV coinfection in children has lagged behind adult populations.
• Addressing the unique challenges of TB-HIV in children is critical for global health initiatives.

Approach:

• This review synthesizes recent research on the prevention, diagnosis, and treatment of HIV-associated TB in children.
• It evaluates current strategies and highlights emerging tools and therapeutic approaches.
• Key areas requiring further investigation are identified to guide future research efforts.

Key Points:

• Preventive measures like vaccination and TB preventive treatment require optimization for children living with HIV (CLHIV).
• Diagnosing TB in CLHIV remains challenging, though novel diagnostic tools show promise for improved accuracy and feasibility.
• Shorter TB treatment regimens and better understanding of antiretroviral-TB drug interactions are advancing care, but evidence gaps persist, especially for young children and drug-resistant TB.

Conclusions:

• Significant advancements have been made in TB-HIV coinfection management for children, yet substantial challenges remain.
• Further research is essential to optimize diagnostics, refine treatment strategies, and address drug-drug interactions, particularly in vulnerable pediatric populations.
• Accelerated efforts are needed to reduce the global burden of TB on CLHIV and improve child survival rates.