Clinical correlates of tuberculosis co-infection in HIV-infected children hospitalized in Peru.
BACKGROUND
In developing countries, tuberculosis (TB) is responsible for almost 250,000 deaths among children yearly. Active TB in children with human immunodeficiency virus (HIV) infection is difficult to diagnose and progresses rapidly to death. The aim of this preliminary study was to investigate the prevalence and clinical correlates of TB-related illness among HIV-infected children admitted to an infectious diseases ward in Peru, a country where TB is highly endemic.


METHODS
Forty-seven HIV-infected children admitted for a suspected infectious process in a Peruvian hospital were investigated for evidence of clinical tuberculosis by auramine stain, culture, and polymerase chain reaction (PCR) of clinical specimens.


RESULTS
Eight children (17%) had evidence of tuberculosis, including five with positive cultures and three with positive PCR tests only. Weight loss was the only feature associated with a positive test for tuberculosis. Radiological changes were very common in both TB-positive and TB-negative groups and these changes were not useful to identify TB-positive cases.


CONCLUSIONS
Weight loss may be used to identify high-risk HIV positive children who require more aggressive evaluation for tuberculosis. Radiological changes were common in both TB-positive and TB-negative groups.
Ramírez-Cardich
María E
ME
Asociación Benéfica Proyectos en Informática, Salud, Medicina, y Agricultura (A.B. PRISMA), Lima, Peru.
Kawai
Vivian
V
Oberhelman
Richard A
RA
Bautista
Christian T
CT
Castillo
María E
ME
Gilman
Robert H
RH
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology*; D001576:Benzophenoneidum; D002648:Child; D002675:Child, Preschool; D003470:Culture Media; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006801:Humans; D007223:Infant; D008297:Male; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D010568:Peru; D016133:Polymerase Chain Reaction; D013194:Staining and Labeling / Q000379:methods; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology*; D015431:Weight Loss
D003470:Culture Media; D001576:Benzophenoneidum