The impact of HIV and antiretroviral therapy on TB risk in children: a systematic review and meta-analysis

P J Dodd, A J Prendergast, C Beecroft, B Kampmann, J A Seddon, P J Dodd, A J Prendergast, C Beecroft, B Kampmann, J A Seddon

Abstract

Background: Children (<15 years) are vulnerable to TB disease following infection, but no systematic review or meta-analysis has quantified the effects of HIV-related immunosuppression or antiretroviral therapy (ART) on their TB incidence.

Objectives: Determine the impact of HIV infection and ART on risk of incident TB disease in children.

Methods: We searched MEDLINE and Embase for studies measuring HIV prevalence in paediatric TB cases ('TB cohorts') and paediatric HIV cohorts reporting TB incidence ('HIV cohorts'). Study quality was assessed using the Newcastle-Ottawa tool. TB cohorts with controls were meta-analysed to determine the incidence rate ratio (IRR) for TB given HIV. HIV cohort data were meta-analysed to estimate the trend in log-IRR versus CD4%, relative incidence by immunological stage and ART-associated protection from TB.

Results: 42 TB cohorts and 22 HIV cohorts were included. In the eight TB cohorts with controls, the IRR for TB was 7.9 (95% CI 4.5 to 13.7). HIV-infected children exhibited a reduction in IRR of 0.94 (95% credible interval: 0.83-1.07) per percentage point increase in CD4%. TB incidence was 5.0 (95% CI 4.0 to 6.0) times higher in children with severe compared with non-significant immunosuppression. TB incidence was lower in HIV-infected children on ART (HR: 0.30; 95% CI 0.21 to 0.39). Following initiation of ART, TB incidence declined rapidly over 12 months towards a HR of 0.10 (95% CI 0.04 to 0.25).

Conclusions: HIV is a potent risk factor for paediatric TB, and ART is strongly protective. In HIV-infected children, early diagnosis and ART initiation reduces TB risk.

Trial registration number: CRD42014014276.

Keywords: Tuberculosis.

Conflict of interest statement

Competing interests: None declared.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Review and Meta-Analyses flow chart for systematic review (*one study included both a TB and HIV cohort17).
Figure 2
Figure 2
Forest plot for meta-analysis of HIV risk in children aged 2=69.8%). RE, random effects.
Figure 3
Figure 3
Forest plot for Bayesian meta-analysis of HIV risk in children aged

Figure 4

Relative TB incidence in children…

Figure 4

Relative TB incidence in children aged <15 years with HIV by WHO immunological staging (I 2 =87.1%).

Figure 4
Relative TB incidence in children aged 2=87.1%).

Figure 5

Forest plot for meta-analysis of…

Figure 5

Forest plot for meta-analysis of relation between incidence rate ratio for TB incidence…

Figure 5
Forest plot for meta-analysis of relation between incidence rate ratio for TB incidence and CD4% in children aged

Figure 6

Forest plot of protection on…

Figure 6

Forest plot of protection on antiretroviral therapy against TB incidence in children <15 years with HIV infection (I 2…15>

Figure 6
Forest plot of protection on antiretroviral therapy against TB incidence in children 2=79.0%). RE, random effects.

Figure 7

Meta-regression of protection from TB…

Figure 7

Meta-regression of protection from TB incidence in children <15 years by time-on-antiretroviral therapy…

Figure 7
Meta-regression of protection from TB incidence in children
All figures (7)
Similar articles
Cited by
References
    1. Marais BJ, Gie RP, Schaaf HS, et al. . The natural history of childhood intra-thoracic tuberculosis: a critical review of literature from the pre-chemotherapy era. Int J Tuberc Lung Dis 2004;8:392–402. - PubMed
    1. Dodd PJ, Gardiner E, Coghlan R, et al. . Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study. Lancet Glob Health 2014;2:e453–9. 10.1016/S2214-109X(14)70245-1 - DOI - PubMed
    1. World Health Organization. Global tuberculosis report 2015. Geneva, 2015.
    1. UNAIDS. 2014 progress report on the global plan. Geneva, 2014.
    1. Tobin NH, Aldrovandi GM. Immunology of pediatric HIV infection. Immunol Rev 2013;254:143–69. 10.1111/imr.12074 - DOI - PMC - PubMed
Show all 90 references
MeSH terms
Substances
Related information
Full text links [x]
[x]
Cite
Copy Download .nbib .nbib
Format: AMA APA MLA NLM

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

Follow NCBI
Figure 4
Figure 4
Relative TB incidence in children aged 2=87.1%).
Figure 5
Figure 5
Forest plot for meta-analysis of relation between incidence rate ratio for TB incidence and CD4% in children aged

Figure 6

Forest plot of protection on…

Figure 6

Forest plot of protection on antiretroviral therapy against TB incidence in children <15 years with HIV infection (I 2…15>

Figure 6
Forest plot of protection on antiretroviral therapy against TB incidence in children 2=79.0%). RE, random effects.

Figure 7

Meta-regression of protection from TB…

Figure 7

Meta-regression of protection from TB incidence in children <15 years by time-on-antiretroviral therapy…

Figure 7
Meta-regression of protection from TB incidence in children
All figures (7)
Similar articles
Cited by
References
    1. Marais BJ, Gie RP, Schaaf HS, et al. . The natural history of childhood intra-thoracic tuberculosis: a critical review of literature from the pre-chemotherapy era. Int J Tuberc Lung Dis 2004;8:392–402. - PubMed
    1. Dodd PJ, Gardiner E, Coghlan R, et al. . Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study. Lancet Glob Health 2014;2:e453–9. 10.1016/S2214-109X(14)70245-1 - DOI - PubMed
    1. World Health Organization. Global tuberculosis report 2015. Geneva, 2015.
    1. UNAIDS. 2014 progress report on the global plan. Geneva, 2014.
    1. Tobin NH, Aldrovandi GM. Immunology of pediatric HIV infection. Immunol Rev 2013;254:143–69. 10.1111/imr.12074 - DOI - PMC - PubMed
Show all 90 references
MeSH terms
Substances
Related information
Full text links [x]
[x]
Cite
Copy Download .nbib .nbib
Format: AMA APA MLA NLM
Figure 6
Figure 6
Forest plot of protection on antiretroviral therapy against TB incidence in children 2=79.0%). RE, random effects.
Figure 7
Figure 7
Meta-regression of protection from TB incidence in children
All figures (7)

References

    1. Marais BJ, Gie RP, Schaaf HS, et al. . The natural history of childhood intra-thoracic tuberculosis: a critical review of literature from the pre-chemotherapy era. Int J Tuberc Lung Dis 2004;8:392–402.
    1. Dodd PJ, Gardiner E, Coghlan R, et al. . Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study. Lancet Glob Health 2014;2:e453–9. 10.1016/S2214-109X(14)70245-1
    1. World Health Organization. Global tuberculosis report 2015. Geneva, 2015.
    1. UNAIDS. 2014 progress report on the global plan. Geneva, 2014.
    1. Tobin NH, Aldrovandi GM. Immunology of pediatric HIV infection. Immunol Rev 2013;254:143–69. 10.1111/imr.12074
    1. World Health Organization. Guidelines on when to start antiretroviral therapy and pre-exposure prophylaxis for HIV. Geneva: WHO, 2015.
    1. Corbett EL, Watt CJ, Walker N, et al. . The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med 2003;163:1009 10.1001/archinte.163.9.1009
    1. Williams BG, Dye C. Antiretroviral drugs for tuberculosis control in the era of HIV/AIDS. Science 2003;301:1535–7. 10.1126/science.1086845
    1. Williams BG, Granich R, De Cock KM, et al. . Antiretroviral therapy for tuberculosis control in nine African countries. Proc Natl Acad Sci USA 2010;107:19485–9. 10.1073/pnas.1005660107
    1. Suthar AB, Lawn SD, del Amo J, et al. . Antiretroviral therapy for prevention of tuberculosis in adults with HIV: a systematic review and meta-analysis. PLoS Med 2012;9:e1001270 10.1371/journal.pmed.1001270
    1. Pretorius C, Menzies NA, Chindelevitch L, et al. . The potential effects of changing HIV treatment policy on tuberculosis outcomes in South Africa: results from three tuberculosis-HIV transmission models. AIDS 2014;28(Suppl 1):S25–34. 10.1097/QAD.0000000000000085
    1. Williams BG, Granich R, Chauhan LS, et al. . The impact of HIV/AIDS on the control of tuberculosis in India. Proc Natl Acad Sci USA 2005;102:9619–24. 10.1073/pnas.0501615102
    1. Moher D, Liberati A, Tetzlaff J, et al. . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009;151:264–9. 10.7326/0003-4819-151-4-200908180-00135
    1. Crook AM, Turkova A, Musiime V, et al. . Tuberculosis incidence is high in HIV-infected African children but is reduced by co-trimoxazole and time on antiretroviral therapy. BMC Med 2016;14:50 10.1186/s12916-016-0593-7
    1. Wells GA, Shea B, O'connell D, et al. . The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses, 2000. (accessed 1 Jan 2008).
    1. Viechtbauer W. Conducting meta-analyses in R with the metafor package. J Stat Soft 2010;36:1–48. 10.18637/jss.v036.i03
    1. Jaganath D, Zalwango S, Okware B, et al. . Contact investigation for active tuberculosis among child contacts in Uganda. Clin Infect Dis 2013;57:1685–92. 10.1093/cid/cit645
    1. Ade S, Harries AD, Trébucq A, et al. . The burden and outcomes of childhood tuberculosis in Cotonou, Benin. Public Health Action 2013;3:15–19. 10.5588/pha.12.0055
    1. Berggren Palme I, Gudetta B, Bruchfeld J, et al. . Detection of Mycobacterium tuberculosis in gastric aspirate and sputum collected from Ethiopian HIV-positive and HIV-negative children in a mixed in- and outpatient setting. Acta Paediatr 2004;93:311–15. 10.1111/j.1651-2227.2004.tb02953.x
    1. Berggren Palme I, Gudetta B, Degefu H, et al. . A controlled estimate of the risk of HIV infection in Ethiopian children with tuberculosis. Epidemiol Infect 2001;127:517–25. 10.1017/S0950268801006215
    1. Bhat GJ, Diwan VK, Chintu C, et al. . HIV, BCG and TB in children: a case control study in Lusaka, Zambia. J Trop Pediatr 1993;39:219–23. 10.1093/tropej/39.4.219
    1. Bobossi-Serengbe G, Tembeti PJ, Mobima T, et al. . [Tuberculosis and HIV co-infection among children hospitalized in Bangui (Central African Republic)]. Arch Pediatr 2005;12:1215–20. 10.1016/j.arcped.2005.04.083
    1. Campos-Herrero Navas MI, Rodriguez Villalobos H, Perera Gonzalez A, et al. . [Tuberculosis en pediatric patients in the island of Gran Canaria]. An Esp Pediatr 1997;46:561–4.
    1. Cathebras P, Vohito JA, Yete ML, et al. . [Tuberculosis and human immunodeficiency virus infection in the Central African Republic]. Med Trop (Mars) 1988;48:401–7.
    1. Chintu C, Bhat G, Luo C, et al. . Seroprevalence of human immunodeficiency virus type 1 infection in Zambian children with tuberculosis. Pediatr Infect Dis J 1993;12:499–504. 10.1097/00006454-199306000-00008
    1. Chintu C, Dupont HL, Kaile T, et al. . Human immunodeficiency virus-associated diarrhea and wasting in Zambia: selected risk factors and clinical associations. Am J Trop Med Hyg 1998;59:38–41.
    1. Chintu C, Luo C, Bhat G, et al. . Impact of the human immunodeficiency virus type-1 on common pediatric illnesses in Zambia. J Trop Pediatr 1995;41:348–53. 10.1093/tropej/41.6.348
    1. Daniel OJ, Ogunfowora OB, Oladapo OT. HIV sero-prevalence among children diagnosed with TB in Nigeria. Trop Doct 2007;37:268–9. 10.1258/004947507782333080
    1. Edwards DJ, Kitetele F, Van Rie A. Agreement between clinical scoring systems used for the diagnosis of pediatric tuberculosis in the HIV era. Int J Tuberc Lung Dis 2007;11:263–9.
    1. Espinal MA, Reingold AL, Perez G, et al. . Human immunodeficiency virus infection in children with tuberculosis in Santo Domingo, Dominican Republic: prevalence, clinical findings, and response to antituberculosis treatment. J Acquir Immune Defic Syndr Hum Retrovirol 1996;13:155-9.
    1. Feldacker C, Tweya H, Keiser O, et al. . Characteristics of adults and children diagnosed with tuberculosis in Lilongwe, Malawi: findings from an integrated HIV/TB clinic. Trop Med Int Health 2012;17:1108–16. 10.1111/j.1365-3156.2012.03041.x
    1. Gava C, Malacarne J, Rios DPG, et al. . Tuberculosis in indigenous children in the Brazilian Amazon. Rev Saude Publica 2013;47:77–85. 10.1590/S0034-89102013000100011
    1. Geoghagen M, Farr JA, Hambleton I, et al. . Tuberculosis and HIV co-infections in Jamaican children. West Indian Med J 2004;53:339–45.
    1. Henegar C, Behets F, Vanden Driessche K, et al. . Impact of HIV on clinical presentation and outcomes of tuberculosis treatment at primary care level. Int J Tuberc Lung Dis 2013;17:1411–13. 10.5588/ijtld.13.0151
    1. Hesseling AC, Cotton MF, Jennings T, et al. . High incidence of tuberculosis among HIV-infected infants: evidence from a South African population-based study highlights the need for improved tuberculosis control strategies. Clin Infect Dis 2009;48:108-14.
    1. Hussain T, Sinha S, Talan S, et al. . Seroprevalence of HIV infection among paediatric tuberculosis patients in Agra, India: a hospital-based study. Tuberculosis (Edinb) 2007;87:7–11. 10.1016/j.tube.2006.01.001
    1. Iriso R, Mudido PM, Karamagi C, et al. . The diagnosis of childhood tuberculosis in an HIV-endemic setting and the use of induced sputum. Int J Tuberc Lung Dis 2005;9:716–26.
    1. Jain SK, Ordonez A, Kinikar A, et al. . Pediatric tuberculosis in young children in India: a prospective study. Biomed Res Int 2013;2013:783698 10.1155/2013/783698
    1. Jensen J, Álvaro-Meca A, Micheloud D, et al. . Reduction in mycobacterial disease among HIV-infected children in the highly active antiretroviral therapy era (1997-2008). Pediatr Infect Dis J 2012;31:278–83. 10.1097/INF.0b013e318239e268
    1. Llerena C, Fadul SE, Garzón MC, et al. . [Drug-resistant Mycobacterium tuberculosis in children under 15 years]. Biomedica 2010;30:362–70. 10.7705/biomedica.v30i3.270
    1. Luo C, Chintu C, Bhat G, et al. . Human immunodeficiency virus type-1 infection in Zambian children with tuberculosis: changing seroprevalence and evaluation of a thioacetazone-free regimen. Tuber Lung Dis 1994;75:110–15. 10.1016/0962-8479(94)90039-6
    1. Madhi SA, Gray GE, Huebner RE, et al. . Correlation between CD4+ lymphocyte counts, concurrent antigen skin test and tuberculin skin test reactivity in human immunodeficiency virus type 1-infected and -uninfected children with tuberculosis. Pediatr Infect Dis J 1999;18:800–5. 10.1097/00006454-199909000-00011
    1. Mehta S, Mugusi FM, Bosch RJ, et al. . A randomized trial of multivitamin supplementation in children with tuberculosis in Tanzania. Nutr J 2011;10:120 10.1186/1475-2891-10-120
    1. Miranda AE, Dietze R, Maciel EL, et al. . Tuberculosis and AIDS co-morbidity in children: linkage of databases from Espirito Santo State, Brazil. J Trop Pediatr 2011;57:296–8. 10.1093/tropej/fmq087
    1. Mukadi YD, Wiktor SZ, Coulibaly IM, et al. . Impact of HIV infection on the development, clinical presentation, and outcome of tuberculosis among children in Abidjan, Cote d'Ivoire. AIDS 1997;11:1151–8. 10.1097/00002030-199709000-00011
    1. Berggren Palme I, Gudetta B, Bruchfeld J, et al. . Impact of human immunodeficiency virus 1 infection on clinical presentation, treatment outcome and survival in a cohort of Ethiopian children with tuberculosis. Pediatr Infect Dis J 2002;21:1053–61. 10.1097/01.inf.0000036090.75121.f3
    1. Panigatti P, Ratageri VH, Shivanand I, et al. . Profile and outcome of childhood tuberculosis treated with DOTS—an observational study. Indian J Pediatr 2014;81:9–14. 10.1007/s12098-013-1175-8
    1. Rachow A, Clowes P, Saathoff E, et al. . Increased and expedited case detection by Xpert MTB/RIF assay in childhood tuberculosis: a prospective cohort study. Clin Infect Dis 2012;54:1388-96.
    1. Ramos JM, Reyes F, Tesfamariam A. Childhood and adult tuberculosis in a rural hospital in Southeast Ethiopia: a ten-year retrospective study. BMC Public Health 2010;10:215 10.1186/1471-2458-10-215
    1. Rose MV, Kimaro G, Nissen TN, et al. . QuantiFERON-TB gold in-tube performance for diagnosing active tuberculosis in children and adults in a high burden setting. PLoS ONE 2012;7:e37851 10.1371/journal.pone.0037851
    1. Sassan-Morokro M, De Cock KM, Ackah A, et al. . Tuberculosis and HIV infection in children in Abidjan, Cote d'Ivoire. Trans R Soc Trop Med Hyg 1994;88:178–81. 10.1016/0035-9203(94)90285-2
    1. Schaaf HS, Hesseling AC, Rautenbach C, et al. . Trends in childhood drug-resistant tuberculosis in South Africa: a window into the wider epidemic? Int J Tuberc Lung Dis 2014;18:770–3. 10.5588/ijtld.13.0069
    1. Seddon JA, Hesseling AC, Marais BJ, et al. . The evolving epidemic of drug-resistant tuberculosis among children in Cape Town, South Africa. Int J Tuberc Lung Dis 2012;16:928–33. 10.5588/ijtld.11.0679
    1. Shahab T, Zoha MS, Malik MA, et al. . Prevalence of human immunodeficiency virus infection in children with tuberculosis. Indian Pediatr 2004;41:595–9. 10.1016/j.arcmed.2004.09.002
    1. Thomas TA, Heysell SK, Moodley P, et al. . Intensified specimen collection to improve tuberculosis diagnosis in children from Rural South Africa, an observational study. BMC Infect Dis 2014;14:11 10.1186/1471-2334-14-11
    1. Yassin MA, Petrucci R, Garie KT, et al. . Can interferon-gamma or interferon-gamma-induced-protein-10 differentiate tuberculosis infection and disease in children of high endemic areas? PLoS ONE 2011;6:e23733 10.1371/journal.pone.0023733
    1. Kwara A, Enimil A, Gillani FS, et al. . Pharmacokinetics of first-line antituberculosis drugs using WHO revised dosage in children with tuberculosis with and without HIV coinfection. J Pediatr Infect Dis Soc 2016;5:356-65. 10.1093/jpids/piv035
    1. López-Varela E, Augusto O, Gondo K, et al. . Incidence of tuberculosis in children under the age of three in Manhiça, rural southern Mozambique Pediatr Infect Dis J 2015;34:686-92.
    1. Perfura Yone EW, Mbarga AE, Kuaban C. Impact de l'infection à VIH sur la tuberculose de l'enfant à Yaoundé, Cameroun. Rev Mal Respir 2012;29:1095–103. 10.1016/j.rmr.2012.05.017
    1. Abuogi LL, Mwachari C, Leslie HH, et al. . Impact of expanded antiretroviral use on incidence and prevalence of tuberculosis in children with HIV in Kenya. Int J Tuberc Lung Dis 2013;17:1291–7. 10.5588/ijtld.12.0740
    1. Alarcón JO, Freimanis-Hance L, Krauss M, et al. . Opportunistic and other infections in HIV-infected children in Latin America compared to a similar cohort in the United States. AIDS Res Hum Retroviruses 2012;28:282–8. 10.1089/AID.2011.0057
    1. Auld AF, Tuho MZ, Ekra KA, et al. . Tuberculosis in human immunodeficiency virus-infected children starting antiretroviral therapy in Cote d'Ivoire. Int J Tuberc Lung Dis 2014;18:381–7. 10.5588/ijtld.13.0395
    1. Bakeera-Kitaka S, Conesa-Botella A, Dhabangi A, et al. . Tuberculosis in human immunodeficiency virus infected Ugandan children starting on antiretroviral therapy. Int J Tuberc Lung Dis 2011;15:1082–6. 10.5588/ijtld.10.0538
    1. Braitstein P, Nyandiko W, Vreeman R, et al. . The clinical burden of tuberculosis among human immunodeficiency virus-infected children in Western Kenya and the impact of combination antiretroviral treatment. Pediatr Infect Dis J 2009;28:626–32. 10.1097/INF.0b013e31819665c5
    1. Brennan AT, Maskew M, Schnippel K, et al. . Risk factors associated with TB in children receiving ART in a South African multicenter HIV cohort. Top Antivir Med 2014;22:484–5.
    1. Ciaranello A, Lu Z, Ayaya S, et al. . Incidence of World Health Organization stage 3 and 4 events, tuberculosis and mortality in untreated, HIV-infected children enrolling in care before 1 year of age: an IeDEA (International Epidemiologic Databases To Evaluate AIDS) east Africa regional analysis. Pediatr Infect Dis J 2014;33:623–9. 10.1097/INF.0000000000000223
    1. Curtis AJ, Marshall CS, Spelman T, et al. . Incidence of WHO stage 3 and 4 conditions following initiation of anti-retroviral therapy in resource limited settings. PLoS ONE 2012;7:e52019 10.1371/journal.pone.0052019
    1. Dankner WM, Lindsey JC, Levin MJ, Pediatric ACTGPT. Correlates of opportunistic infections in children infected with the human immunodeficiency virus managed before highly active antiretroviral therapy. Pediatr Infect Dis J 2001;20:40–8. 10.1097/00006454-200101000-00008
    1. De Beaudrap P, Boullé C, Lewden C, et al. . Morbidity after antiretroviral therapy initiation in HIV-1-infected children in West Africa: temporal trends and relation to CD4 count. Pediatr Infect Dis J 2013;32:354–60. 10.1097/INF.0b013e318278b222
    1. Edmonds A, Lusiama J, Napravnik S, et al. . Anti-retroviral therapy reduces incident tuberculosis in HIV-infected children. Int J Epidemiol 2009;38:1612–21. 10.1093/ije/dyp208
    1. Gray DM, Workman LJ, Lombard CJ, et al. . Isoniazid preventive therapy in HIV-infected children on antiretroviral therapy: a pilot study. Int J Tuberc Lung Dis 2014;18:322–7. 10.5588/ijtld.13.0354
    1. Kouakoussui A, Fassinou P, Anaky MF, et al. . Respiratory manifestations in HIV-infected children pre- and post-HAART in Abidjan, the Ivory Coast. Paediatr Respir Rev 2004;5:311–15. 10.1016/j.prrv.2004.07.008
    1. Li N, Manji KP, Spiegelman D, et al. . Incident tuberculosis and risk factors among HIV-infected children in Tanzania. AIDS 2013;27:1273–81. 10.1097/QAD.0b013e32835ecb24
    1. Martinson NA, Moultrie H, van Niekerk R, et al. . HAART and risk of tuberculosis in HIV-infected South African children: a multi-site retrospective cohort. Int J Tuberc Lung Dis 2009;13:862–7.
    1. Prasitsuebsai W, Kariminia A, Puthanakit T, et al. . Impact of antiretroviral therapy on opportunistic infections of HIV-infected children in the therapeutic research, education and AIDS training Asia pediatric HIV observational database. Pediatr Infect Dis J 2014;33:747–52. 10.1097/INF.0000000000000226
    1. Thomas P, Bornschlegel K, Singh TP, et al. . Tuberculosis in human immunodeficiency virus-infected and human immunodeficiency virus-exposed children in New York City. The New York City Pediatric Spectrum of HIV Disease Consortium. Pediatr Infect Dis J 2000;19:700–6. 10.1097/00006454-200008000-00006
    1. Walters E, Cotton MF, Rabie H, et al. . Clinical presentation and outcome of tuberculosis in human immunodeficiency virus infected children on anti-retroviral therapy. BMC Pediatr 2008;8:1 10.1186/1471-2431-8-1
    1. Walters E, Duvenhage J, Draper HR, et al. . Severe manifestations of extrapulmonary tuberculosis in HIV-infected children initiating antiretroviral therapy before 2 years of age. Arch Dis Child 2014;99:998–1003. 10.1136/archdischild-2013-305509
    1. Yirdaw KD, Jerene D, Gashu Z, et al. . Beneficial effect of isoniazid preventive therapy and antiretroviral therapy on the incidence of tuberculosis in people living with HIV in Ethiopia. PLoS ONE 2014;9:e104557 10.1371/journal.pone.0104557
    1. Zar HJ, Cotton MF, Strauss S, et al. . Effect of isoniazid prophylaxis on mortality and incidence of tuberculosis in children with HIV: randomised controlled trial. BMJ 2007;334:136 10.1136/bmj.39000.486400.55
    1. Lawn SD, Myer L, Edwards D, et al. . Short-term and long-term risk of tuberculosis associated with CD4 cell recovery during antiretroviral therapy in South Africa. AIDS 2009;23:1717–25. 10.1097/QAD.0b013e32832d3b6d
    1. Gupta A, Wood R, Kaplan R, et al. . Tuberculosis incidence rates during 8 years of follow-up of an antiretroviral treatment cohort in South Africa: comparison with rates in the community. PLoS ONE 2012;7:e34156 10.1371/journal.pone.0034156
    1. Picat MQ, Lewis J, Musiime V, et al. . Predicting patterns of long-term CD4 reconstitution in HIV-infected children starting antiretroviral therapy in sub-Saharan Africa: a cohort-based modelling study. PLoS Med 2013;10:e1001542 10.1371/journal.pmed.1001542
    1. García F, de Lazzari E, Plana M, et al. . Long-term CD4+ T-cell response to highly active antiretroviral therapy according to baseline CD4+ T-cell count. J Acquir Immune Defic Syndr 2004;36:702–13. 10.1097/00126334-200406010-00007
    1. Moore RD, Keruly JC. CD4+ cell count 6 years after commencement of highly active antiretroviral therapy in persons with sustained virologic suppression. Clin Infect Dis 2007;44:441–6. 10.1086/510746
    1. Jenkins HE, Yuen CM, Rodriguez CA, et al. . Mortality among children diagnosed with tuberculosis: Systematic review and meta-analysis. Lancet Infect Dis. Published Online First: 7 Dec 2016. doi:10.1016/S1473-3099(16)30474-1.
    1. Bamford A, Turkova A, Lyall H, et al. . Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV-1 infection 2015: optimizing health in preparation for adult life. HIV Med Published Online First: 3 Feb 2015. doi:10.1111/hiv.12217 10.1111/hiv.12217
    1. Lewis J, Walker AS, Castro H, et al. . Age and CD4 count at initiation of antiretroviral therapy in HIV-infected children: effects on long-term T-cell reconstitution. J Infect Dis 2012;205:548–56. 10.1093/infdis/jir787
    1. Denkinger CM, Kampmann B, Ahmed S, et al. . Modeling the impact of novel diagnostic tests on pediatric and extrapulmonary tuberculosis. BMC Infect Dis 2014;14:477 10.1186/1471-2334-14-477
    1. Frigati LJ, Kranzer K, Cotton MF, et al. . The impact of isoniazid preventive therapy and antiretroviral therapy on tuberculosis in children infected with HIV in a high tuberculosis incidence setting. Thorax 2011;66:496–501. 10.1136/thx.2010.156752

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅