Treatment Outcomes of Children with HIV Infection and Drug-Resistant TB in Three Provinces in South Africa, 2005–2008

Details

• Alternative Title:
  Pediatr Infect Dis J
• Personal Author:
  Hall, Eric W. ; Morris, Sapna B. ; Moore, Brittany K. ; Erasmus, Linda ; Odendaal, Ronel ; Menzies, Heather ; van der Walt, Martie ; Smith, Sarah E.
• Description:
  Objective ; To describe outcomes of HIV-infected pediatric patients with drug-resistant tuberculosis (DR TB). ; Methods ; Demographic, clinical, and laboratory data from pediatric patient charts treated for DR TB during 2005–2008 were collected retrospectively from five MDR TB hospitals in South Africa. Data were summarized and Pearson’s chi-squared test or Fisher’s exact test were used to assess differences in variables of interest by HIV status. A time-to-event analysis was conducted using days from start of treatment to death. Variables of interest were first assessed using the Kaplan-Meier method. Cox proportional hazard models were fit to estimate crude and adjusted hazard ratios. ; Results ; Of 423 eligible participants, 398 (95%) had culture-confirmed DR-TB and 238 (56%) were HIV-infected. A total of 54% were underweight, 42% were male and median age was 10.7 years (IQR: 5.5–15.3). Of the 423 participants, 245 (58%) were successfully treated, 69 (16%) died, treatment failed in 3 (1%), 36 (9%) were lost to follow-up, and 70 (17%) were still on treatment, transferred or had unknown outcomes. Time to death differed by HIV status (p=0.008), sex (p<0.001), year of TB diagnosis (p=0.05) and weight status (p=0.002). Over the two-year risk period, the adjusted rate of death was 2-fold higher among participants with HIV compared to HIV-negative participants (aHR=2.28; 95% CI: 1.11, 4.68). ; Conclusions ; Male, underweight, and HIV-infected children with DR TB were more likely to experience death when compared to other children with DR TB within this study population.
• Subjects:
  • Adolescent
  • Anti-HIV Agents
  • Antitubercular Agents
  • Child
  • Child, Preschool
  • Coinfection
  • Female
  • HIV Infections
  • Humans
  • Infant
  More +
• Keywords:
  • HIV
  • pediatric
  • drug resistance
  • tuberculosis
• Source:
  Pediatr Infect Dis J. 36(12):e322-e327
• Pubmed ID:
  28746263
• Pubmed Central ID:
  PMC5797992
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  36
• Issue:
  12
• Download URL:
  https://stacks.cdc.gov/view/cdc/51425/cdc_51425_DS1.pdf
• File Type:
  [PDF - 444.83 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c0cf66477c68530219cc83083124ebb3aac70da2c7f36a82a6086a58a725b023