title: Tuberculosis in HIV-infected infants, children, and adolescents in Latin America.
abstract: OBJECTIVE
  To evaluate the occurrence, clinical presentations and diagnostic methods for tuberculosis in a cohort of HIV-infected infants, children and adolescents from Latin America.
  
  
  METHODS
  A retrospective analysis of children with tuberculosis and HIV was performed within a prospective observational cohort study conducted at multiple clinical sites in Latin America.
  
  
  RESULTS
  Of 1114 HIV-infected infants, children, and adolescents followed from 2002 to 2011, 69 that could be classified as having confirmed or presumed tuberculosis were included in this case series; 52.2% (95% CI: 39.8-64.4%) had laboratory-confirmed tuberculosis, 15.9% (95% CI: 8.2-26.7%) had clinically confirmed disease and 31.9% (95% CI: 21.2-44.2%) had presumed tuberculosis. Sixty-six were perinatally HIV-infected. Thirty-two (61.5%) children had a history of contact with an adult tuberculosis case; however information on exposure to active tuberculosis was missing for 17 participants. At the time of tuberculosis diagnosis, 39 were receiving antiretroviral therapy. Sixteen of these cases may have represented immune reconstitution inflammatory syndrome.
  
  
  CONCLUSIONS
  Our study emphasizes the need for adequate contact tracing of adult tuberculosis cases and screening for HIV or tuberculosis in Latin American children diagnosed with either condition. Preventive strategies in tuberculosis-exposed, HIV-infected children should be optimized.
authors.affiliation: Westat, Rockville, USA. Electronic address: Margotkrauss@westat.com.
authors.forename: Margot R
authors.initials: MR
authors.lastname: Krauss
authors.affiliation: Westat, Rockville, USA.
authors.forename: D Robert
authors.initials: DR
authors.lastname: Harris
authors.affiliation: Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Thalita
authors.initials: T
authors.lastname: Abreu
authors.affiliation: Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Fabiana G
authors.initials: FG
authors.lastname: Ferreira
authors.affiliation: Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico.
authors.forename: Noris Pavia
authors.initials: NP
authors.lastname: Ruz
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Worrell
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, USA.
authors.forename: Rohan
authors.initials: R
authors.lastname: Hazra
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology*; D000293:Adolescent; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007843:Latin America / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
keywords: Children; HIV; Latin America; Tuberculosis