Clinical profile, treatment response, and outcome of HIV-TB co-infected children

BackgroundWe studied the clinical presentation, treatment response and outcome in children with HIV-TB co-infection, registered at PCOE, Indira Gandhi Institute of Child Health, Bangalore.MethodsAll 590 HIV infected children registered at our center were evaluated for TB infection. Information on TB was collected by retrospective chart review of these children.ResultsA total of 183 (31%) children had evidence of tuberculosis based on their history, clinical presentation with a positive Mantoux test or bacteriological or radiological evidence and were treated for TB. Of these children 141 had newly detected TB infection. Severe immunodeficiency was found in 43%. Most common type of TB was sputum negative TB (30%). The incidence of IRIS was found to be 8% in our study. History of contact was found in 61%, demonstration of AFB was possible in 30% and tuberculin test was positive in 23%. There was significant treatment response as measured by improvement in nutritional status, and immunological status from the baseline to that after the completion of ATT. Mortality was found to be 3.55%.ConclusionTB is a common co-infection in HIV infected children and diagnosis is often difficult. Response to ATT and ART was excellent.