A study on clinical profile of tuberculosis in HIV children

ABSTRACT

Background: Children born to Human immunodeficiency virus (HIV) positive parents who are not infected with tuberculosis (TB) themselves, are also at higher risk of acquiring TB because of exposure. The source of transmission of TB to a child is usually an adult with sputum-smear positive PTB. To evaluate the clinical, bacteriological and radiological pattern of TB in HIV seropositive children in correlation with CD4 count.Methods: This study was conducted over a period of 12 months from May 2008- April 2009 at GMKMCH Salem. 100 children screened positive for HIV at voluntary counselling and testing centers (VCTC) in Antiretroviral therapy (ART) center and diagnosed to have TB infection as per Revised national tuberculosis control programme (RNTCP) guidelines.Results: Out of the 100 children with HIV and TB infection 62 were males and 38 were females. The ratio was 1.631. The sputum positivity in our study shows that only 9% of the children are sputum positive. Sputum culture for M. Tuberculosis remains the gold standard for the diagnosis of Pulmonary TB. In resource-poor countries, the diagnosis is heavily dependent on the sputum AFB smear. In our study CD4 cell count, less than 300 was observed in 33 children. In these children the predominant X-ray lesions were Hilar adenopathy, lower lobe infiltrations, diffuse infiltrates and miliary mottling. Upper lobe infiltrates was common with higher CD4 count mean 350.Conclusions: With the conventional sputum positivity and Tuberculin test not providing an adequate diagnostic help, familiarity with clinical radiological spectrum of TB and HIV co-infection will help in early diagnosis and improve survival among HIV seropositive children.