Childhood tuberculosis and infection with the human immunodeficiency virus

Abstract

TB in HIV-infected individuals is a major cause of morbidity and mortality in developing countries and poses enormous problems to the health services. Despite the availability of curative therapy, the incidence of TB in children and adults is increasing at an alarming rate and poses a grave threat to TB control programmes in developing countries. Prospective studies to define basic clinical, microbiological and epidemiological features of the resurgence of childhood TB in the light of the HIV epidemic are required.

PIP: Both tuberculosis (TB) and HIV infection have been declared global emergencies by the World Health Organization (WHO). The WHO in 1992 estimated that 9-11 million adults and 1 million children, mostly in developing countries, had been infected with HIV. Approximately 4 million of these people were coinfected with both TB and HIV, 3.12 million of whom were in sub-Saharan Africa. Data from sub-Saharan Africa indicate that a serious TB epidemic linked to HIV infection is also currently underway in children. This paper discusses the scope of the problem, diagnosing pediatric TB, the clinical presentation of TB in HIV-infected children, patient compliance and follow-up, anti-TB treatment, adverse reactions to anti-TB treatment, strategies for prevention, and the role of BCG. The incidence of TB is increasing rapidly among both children and adults despite the availability of curative therapy. Prospective studies are needed in order to define the basic clinical, microbiological, and epidemiological features of the resurgence of childhood TB in the context of the HIV epidemic.