Human immunodeficiency virus infection in children with tuberculosis in Santo Domingo, Dominican Republic: Prevalence, clinical findings, and response to antituberculosis treatment
Human immunodeficiency virus infection in children with tuberculosis in Santo Domingo, Dominican Republic: Prevalence, clinical findings, and response to antituberculosis treatment
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DOI：
10.1097/00042560-199610010-00006
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发表时间：
1996-10-01
期刊：
影响因子：
--
通讯作者：
Gonzalez, G
中科院分区：
文献类型：
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作者：
Espinal, MA;Reingold, AL;Gonzalez, G
我们研究了临床诊断为结核病(TB)的儿童中人类免疫缺陷病毒(HIV)血清阳性率，并比较了多米尼加共和国圣多明各HIV感染儿童和非HIV感染儿童的临床特征和短期抗结核治疗的反应。对18~59个月新发的临床诊断为结核病的儿童进行了HIV抗体检测，记录了他们的临床特征，并评估了他们头2个月标准的异烟肼和利福平联合链霉素和吡嗪酰胺治疗方案的疗效。为了增加可供研究的感染艾滋病毒的结核病儿童的数量，我们还包括了以前已知的感染艾滋病毒的儿童，他们患上了新发结核病。在189名连续登记的临床诊断为结核病的儿童中，有11人(5.8%)感染了艾滋病毒。其他15名以前记录有艾滋病毒感染和新发结核病的儿童可供研究，产生26名艾滋病毒阳性和178名艾滋病毒阴性的结核病儿童。在这204名临床诊断为结核病的儿童中，25名艾滋病毒阳性儿童和156名艾滋病毒阴性儿童被成功随访6个月或直至死亡。艾滋病毒阳性儿童治疗失败的比例为6/21(29%)，而艾滋病毒阴性儿童中仅为5(3%)[相对风险=8.9%，95%可信区间2.926.6；p=0.0004]。与未感染艾滋病毒的儿童相比，感染艾滋病毒的儿童与临床诊断为结核病的儿童相比，更有可能无法通过结核病的标准治疗。如果对这类儿童使用标准治疗方案，必须非常密切地监测治疗反应，并必须迅速对方案进行适当的改变。
We studied human immunodeficiency virus (HIV)-seroprevalence among children with clinically diagnosed tuberculosis (TB) and compared the clinical features and response to short-term anti-TB therapy of children with and without HIV infection in Santo Domingo, Dominican Republic. Children aged 18-59 months with new-onset, clinically diagnosed TB were tested for HIV antibodies, their clinical features were recorded, and their response to a standard 6-month regimen of daily isoniazid and rifampicin with daily streptomycin and pyrazinamide for the first 2 months was assessed. To increase the number of HIV-infected children with TB available for study, we also included children previously known to be HIV infected who developed new-onset TB. Eleven (5.8%) of 189 consecutively enrolled children with clinically diagnosed TB were HIV infected. Fifteen other children with previously documented HIV infection and new-onset TB were available for study, yielding 26 HIV-positive and 178 HIV-negative children with TB. Of these 204 children with clinically diagnosed TB, 25 HIV-positive and 156 HIV-negative children were successfully followed for 6 months or until death. The proportion of HIV-positive children who failed treatment was 6 (29%) of 21 as compared with only 5 (3%) of 156 HIV-negative children [relative risk = 8.9; 95% confidence interval (CI) 2.9, 26.6; p = 0.0004]. HIV-infected children with clinically diagnosed TB are substantially more likely to fail standard treatment for TB than are HIV-uninfected children. If standard treatment regimens are used in such children, response to treatment must be monitored very closely and appropriate changes in the regimen must be made expeditiously.