HIV and Tuberculosis Co-infection in Children: Presentation and Treatment Outcome

Abstract

Summary

Background: The association between tuberculosis (TB) and human immune deficiency virus (HIV) in adults has been well described. There is however, paucity of information on the association, if any, in Nigerian children.

Objectives: The objective of the present study was to determine the prevalence of HIV among children diagnosed with TB and their treatment outcome.

Design: This was a retrospective study of children diagnosed with TB between January 2000 and December 2004 in Sagamu.

Method: Clinical records of children diagnosed with TB were reviewed. The number of HIV seropositive cases among them was also determined. Their demographic characteristics, clinical presentation and treatment outcomes were noted and comparisons made between those who were HIV positive and others who were HIV negative.

Results: Seventy six children comprising 46 males and 30 females (M:F ratio, 1.5:1) were diagnosed with TB. Eight (10.5 percent) of these were HIV-infected. HIV sero-prevalence increased over the years although this was not statistically significant (X2=8.02; p=0.09). The major routes of transmission were mother-to-child (4/8) and blood transfusion (3/8). Only one case of sexually transmitted HIV was observed. HIV-infected children were significantly older than non-infected children (8.5+4.4 v 5.5+3.9 years; p=0.04), and more likely to have a negative Mantoux test. Mortality was significantly higher among children with TB and HIV CO infection than in those who were HIV negative (3/8 vs 2/68; p=0.01).

Conclusions: The study showed a higher HIV sero-prevalence among children with TB than the national average. HIV and TB co-infection was associated with higher mortality. Effective strategies to prevent mother-to-child-transmission of HIV and to improve safe blood transfusion services should be vigorously pursued to stem the tide of HIV infection in children. 

Keywords: Childhood TB, HIV Sero-prevalence, Treatment outcome