431. High Prevalence of Tuberculosis in a Cohort of HIV-infected Children in Northeast Thailand
Session: Poster Abstract Session: HIV Challenges and Complications
Friday, October 21, 2011
Room: Poster Hall B1

Tuberculosis(TB) is one of the most common opportunistic infections in HIV-infected children. Pulmonary parenchymal disease and intrathoracic adenopathy are the most common manifestations of which the diagnosis is difficult.  Early diagnosis and treatment of TB in HIV-infected patient is important.


HIV-infected children aged less than 15 year-old attended Pediatric HIV Clinic, Srinagarind Hospital, Khon Kaen University  who were treated for tuberculosis(TB) were included in this study.  History of TB in family and routine chest X-ray were obtained in every patient . The diagnosis of TB was based on history of TB contact and abnormal chest X-ray that could not be explained by other causes. The demographic data, type of TB, prior antiretroviral therapy(ART) use and outcome were described.


Between  January 1998 to March 2011, 407 cases of HIV-infected children attended the clinic. More than 90% were perinatally-HIV-infected. 161 cases had the diagnosis of TB, giving the prevalence of 39.6%. 46.6% were male. In an analysis of the first 60 cases of TB, 20 out of 52 (38.5%) cases with reliable history on TB contact reported at least 1 family member with TB, almost all of them were parents who were also HIV-infected. Types of TB included pulmonary( 55 cases), pleural (3 cases), miliary TB and TB meningitis (1 case each). Only 2 out of 60 (3.3%) cases had the acid-fast bacilli smear positive.  At the time of TB diagnosis, 70% of cases had not been initiated with highly active antiretroviral therapy. The treatment of TB included isoniazid, rifampicin, pyrazinamide and ethambutol or streptomycin for 2 months, followed by isoniazid and rifampicin for another 7 or 10 months. The mortality in TB and non-TB group were 6.7% and 10.7%, respectively. No case of immune reconstitution was found in this cohort.


Diagnosis and treatment of TB in HIV-infected children before initiation of ART help to simplify the ART regimen and also to decrease pill burden which result in good outcome.

Subject Category: H. HIV/AIDS and other retroviruses

Pagakrong Lumbiganon, MD.1, Pope Kosalaraksa, MD.1 and Piangjit Tharnpaisarn, RN2, (1)Pediatrics, Khon Kaen University, Khon Kaen, Thailand, (2)Khon Kaen University, Khon Kaen, Thailand


P. Lumbiganon, None

P. Kosalaraksa, None

P. Tharnpaisarn, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.