title: Tuberculosis in HIV-infected children in Europe, Thailand and Brazil: paediatric TB-HIV EuroCoord study.
abstract: Centres participating in the Paediatric European Network for Treatment of AIDS (PENTA), including Thailand and Brazil.
  
  
  
  To describe the incidence, presentation, treatment and treatment outcomes of tuberculosis (TB) in human immunodeficiency virus (HIV) infected children.
  
  
  
  Observational study of TB diagnosed in HIV-infected children in 2011-2013.
  
  
  
  Of 4265 children aged <16 years, 127 (3%) were diagnosed with TB: 6 (5%) in Western Europe, 80 (63%) in Eastern Europe, 27 (21%) in Thailand and 14 (11%) in Brazil, with estimated TB incidence rates of respectively 239, 982, 1633 and 2551 per 100 000 person-years (py). The majority (94%) had acquired HIV perinatally. The median age at TB diagnosis was 6.8 years (interquartile range 3.0-11.5). Over half (52%) had advanced/severe World Health Organization stage immunodeficiency; 67 (53%) were not on antiretroviral therapy (ART) at TB diagnosis. Preventive anti-tuberculosis treatment was given to 23% (n = 23) of 102 children diagnosed with HIV before TB. Eleven children had unfavourable TB outcomes: 4 died, 5 did not complete treatment, 1 had recurrent TB and 1 had an unknown outcome. In univariable analysis, previous diagnosis of acquired immune-deficiency syndrome, not being virologically suppressed on ART at TB diagnosis and region (Brazil) were significantly associated with unfavourable TB outcomes.
  
  
  
  Most TB cases were from countries with high TB prevalence. The majority (91%) had favourable outcomes. Universal ART and TB prophylaxis may reduce missed opportunities for TB prevention.
authors: Medical Research Council Clinical Trials Unit at University College London (UCL), Institute of Clinical Trials & Methodology, London, UK.
authors: A
authors: A
authors: Turkova
authors: Medical Research Council Clinical Trials Unit at University College London (UCL), Institute of Clinical Trials & Methodology, London, UK.
authors: E
authors: E
authors: Chappell
authors: Research Unit, Program for HIV Prevention and Treatment (Program for HIV Prevention and Treatment/Institut de Recherche pour le Développement Unités Mixtes Internationales 174), Chiang Mai, Thailand.
authors: S
authors: S
authors: Chalermpantmetagul
authors: Instituto de Infectologia Emilio Ribas, São Paolo, São Paolo, Brazil.
authors: M Della
authors: MD
authors: Negra
authors: Kyiv City Centre for Prevention and Control of AIDS, Kyiv, Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine.
authors: A
authors: A
authors: Volokha
authors: Kryvyi Rih City Centre for Prevention and Control of AIDS, Kryvyi Rih, Ukraine.
authors: N
authors: N
authors: Primak
authors: Donetsk Regional Centre for Prevention and Control of AIDS, Donetsk, Ukraine.
authors: S
authors: S
authors: Solokha
authors: Irkutsk Regional Centre for Prevention and Control of AIDS and Infectious Diseases, Irkutsk, Ukraine.
authors: V
authors: V
authors: Rozenberg
authors: Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine.
authors: G
authors: G
authors: Kiselyova
authors: St Petersburg City Centre for Prevention and Control of AIDS and Infectious Diseases, St Petersburg, Russian Federation.
authors: E
authors: E
authors: Yastrebova
authors: Republican Clinical Hospital of Infectious Diseases, St Petersburg, Russian Federation.
authors: M
authors: M
authors: Miloenko
authors: Marioupol City Centre for Prevention and Control of AIDS, Marioupol, Ukraine.
authors: N
authors: N
authors: Bashakatova
authors: Nakornping Hospital, Chiang Mai, Thailand; ***Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain.
authors: S
authors: S
authors: Kanjanavanit
authors: Medical Research Council Clinical Trials Unit at University College London (UCL), Institute of Clinical Trials & Methodology, London, UK.
authors: J
authors: J
authors: Calvert
authors: Donetsk Regional Centre for Prevention and Control of AIDS, Donetsk, Ukraine.
authors: P
authors: P
authors: Rojo
authors: Riga East University Hospital, Latvian Centre of Infectious Diseases, Riga, Latvia.
authors: S
authors: S
authors: Ansone
authors: Research Unit, Program for HIV Prevention and Treatment (Program for HIV Prevention and Treatment/Institut de Recherche pour le Développement Unités Mixtes Internationales 174), Chiang Mai, Thailand.
authors: G
authors: G
authors: Jourdain
authors: Perinatal Prevention of AIDS Initiative, Odessa, Ukraine.
authors: R
authors: R
authors: Malyuta
authors: Medical Research Council Clinical Trials Unit at University College London (UCL), Institute of Clinical Trials & Methodology, London, UK.
authors: R
authors: R
authors: Goodall
authors: Medical Research Council Clinical Trials Unit at University College London (UCL), Institute of Clinical Trials & Methodology, London, UK.
authors: A
authors: A
authors: Judd
authors: Institute of Child Health, UCL, London, UK.
authors: C
authors: C
authors: Thorne
mesh_terms: D019072:Antibiotic Prophylaxis; D023241:Antiretroviral Therapy, Highly Active; D000995:Antitubercular Agents / Q000627:therapeutic use; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D060085:Coinfection / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014944:World Health Organization
chemical_list: D000995:Antitubercular Agents