Impact of HIV infection on the development, clinical presentation, and outcome of tuberculosis among children in Abidjan, Cote d'Ivoire
Impact of HIV infection on the development, clinical presentation, and outcome of tuberculosis among children in Abidjan, Cote d'Ivoire
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DOI：
10.1097/00002030-199709000-00011
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发表时间：
1997-07-15
期刊：
影响因子：
3.8
通讯作者：
Greenberg, AE
中科院分区：
文献类型：
--
作者：
Mukadi, YD;Wiktor, SZ;Greenberg, AE
目的：为了评估艾滋病毒感染后的发展，临床表现和结核病（TB）的结果在children.Design：病例对照研究和前瞻性队列study.Methods：从1994年3月至1995年11月，0-9岁的儿童与新诊断的结核病在两个门诊结核病中心和两个主要的大学医院在阿比让，科特迪瓦。对儿童进行检查，采集血液样本进行艾滋病毒血清学和淋巴细胞表型分析，进行胸部X线摄影，采集胃吸出物和痰样本进行抗酸杆菌涂片和培养。然后，在标准的6个月抗结核治疗过程中，每2个月对儿童进行一次随访。为了研究结核病的危险因素，年龄和性别游行健康对照儿童被招募的兄弟姐妹之间的儿童转介结核病皮肤testing.Results：总体而言，161名儿童与结核病，包括39（24%）与培养确诊的肺结核，80（50%）与临床诊断的肺结核，和42（26%）与肺外结核。与161名对照儿童相比，结核病儿童更有可能是艾滋病毒血清阳性（19%对0%），过去有结核病接触（55%对16%）和生活在社会经济地位非常低的住房中（24%对6%）。在肺结核放射学异常的分布或肺外结核的部位方面，HIV血清阳性和血清阴性儿童之间没有显著差异。HIV血清反应阳性儿童的死亡率明显高于血清反应阴性儿童（23%对4%;相对危险度为3.6; 95%可信区间为2.0-6.6），所有HIV血清反应阳性儿童的死亡均发生在CD 4百分比为
Objective: To assess the impact of HIV infection upon the development, clinical presentation, and outcome of tuberculosis (TB) among children.Design: Case-control study and prospective cohort study.Methods: From March 1994 to November 1995, children aged 0-9 years with newly diagnosed TB were enrolled at the two outpatient TB centers and the two principal university hospitals in Abidjan, Cote d'Ivoire. Children were examined, blood samples were collected for HIV serology and lymphocyte phenotyping, chest radiography was performed, and gastric aspirates and sputum samples were collected for acid-fast bacilli smear and culture. Children were then followed every 2 months during a standard 6-month course of anti-TB therapy. To examine risk factors for TB, age- and sex-marched healthy control children were enrolled from among the siblings of children referred for TB skin testing.Results: Overall, 161 children with TB were enrolled, including 39 (24%) with culture-confirmed pulmonary TB, 80 (50%) with clinically diagnosed pulmonary TB, and 42 (26%) with extrapulmonary TB. Children with TB were significantly more likely than 161 control children to be HIV-seropositive (19 versus 0%), to have a past TB contact (55 versus 16%) and to live in very low socioeconomic status housing (24 versus 6%). No significant differences between HIV-seropositive and seronegative children were found in the distribution of radiologic abnormalities for pulmonary TB or in the site of extrapulmonary TB. The mortality rate in HIV-seropositive children was significantly higher than in seronegative children (23 versus 4%; relative risk, 3.6; 95% confidence interval, 2.0-6.6), and all deaths in HIV-seropositive children with available lymphocyte subtyping results occurred in those with a CD4 percentage of