Tuberculosis in human immunodeficiency virus-infected children. A family infection.
OBJECTIVE
To study the epidemiologic and clinical features of infection with Mycobacterium tuberculosis in human immunodeficiency virus (HIV)-infected children and their families. PATIENTS AND CLINICAL SETTING: Sixty families of children with HIV infection, children of HIV indeterminate status, and seroreverters underwent follow-up in a comprehensive multidisciplinary program for children and families.


METHODS
Infection with M tuberculosis was diagnosed based on a positive Mantoux test result or a positive culture.


RESULTS
Mycobacterium tuberculosis infection was diagnosed in seven children (three infected with HIV, three seroreverters, and one uninfected sibling of an infected child) from four families (6%). All infections were detected in the period from March 1990 through January 1992. Six of seven children had a history of exposure to M tuberculosis in an HIV-infected adult (parent) who was an intravenous drug user, homeless, and/or noncompliant with the medical regimen. All HIV-infected children and one seroreverter had pulmonary tuberculosis. One child died of complications of tuberculosis and HIV infection. The M tuberculosis isolated from this child was resistant to isoniazid, rifampin, and streptomycin sulfate.


CONCLUSIONS
Tuberculosis is a growing problem among inner-city children born to HIV-infected parents. Children infected with HIV in this study had symptomatic and severe disease with tuberculosis, which reflected the drug susceptibility pattern of M tuberculosis seen in our community.
Bakshi
S S
SS
Department of Pediatrics, Columbia University College of Physicians and Surgeons, St Luke's Roosevelt Hospital Center, New York, NY.
Alvarez
D
D
Hilfer
C L
CL
Sordillo
E M
EM
Grover
R
R
Kairam
R
R
D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D002648:Child; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009519:New York City / Q000453:epidemiology; D011859:Radiography; D012307:Risk Factors; D012720:Severity of Illness Index; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*