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Incident tuberculosis and risk factors among HIV-infected children in Tanzania

机译：坦桑尼亚艾滋病毒感染儿童的结核病突发事件和危险因素

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Objective: To describe the burden of pediatric tuberculosis (TB) in a HIV-infected population and explore the demographic and clinical factors associated with the occurrence of pediatric TB.Design: Longitudinal analysis of a cohort of HIV-infected children.Methods: The endpoint of the study was clinically diagnosed TB. Cox proportional hazard regression was used to explore the predictors of incident TB among HIV-infected children under age 15 years after enrollment into the HIV program.Results: The cohort comprised of 5040 children [median age: 5 years, interquartile range (IQR) 1 -9 years]. During a median follow-up of 0.8 (IQR 0.1 -2.5) years, 376 out of 5040 children met the case definition for TB. The overall incidence of TB was 5.2/100 person-years. In multivariate analyses, older age at enrollment [relative risk (RR) 1.7, 95%, confidence interval (Cl) 1.5-1.8], severe wasting (RR 1.8, 95% Cl 1.3-2.5), severe immune suppression (RR 2.6, 95% Cl 1.8-3.8), anemia (RR 1.4, 95% Cl 1.0-1.9) and WHO stage IV (RR 4.5, 95% Cl 2.4-8.5) were all independently associated with a higher risk of TB. In addition, the use of antiretroviral drugs for more than 180 days reduced the risk of TB by 70% (RR 0.3, 95% Cl 0.2-0.4).Conclusions: Antiretroviral therapy (ART) use is strongly associated with a reduced risk of tuberculosis among HIV-infected children, and should therefore be included in HIV care and treatment programs. Trials of interventions designed to improve the nutritional and hematologic status of these children should also be performed.
机译：目的：描述艾滋病毒感染人群的小儿结核病负担，探讨与小儿结核病发生有关的人口统计学和临床​​因素设计：对一批艾滋病毒感染儿童的纵向分析方法：终点该研究的临床诊断为结核病。使用Cox比例风险回归分析研究了纳入HIV计划后15岁以下的HIV感染儿童中结核病发病率的预测因子。结果：该队列由5040名儿童组成[中位年龄：5岁，四分位间距（IQR）1 -9年]。在0.8年的中位随访（IQR 0.1 -2.5）中，5040名儿童中有376名符合结核病的病例定义。结核病的总发病率为5.2 / 100人年。在多变量分析中，入组时年龄较大[相对风险（RR）1.7，95％，置信区间（Cl）1.5-1.8]，严重浪费（RR 1.8，95％Cl 1.3-2.5），严重免疫抑制（RR 2.6， 95％Cl 1.8-3.8），贫血（RR 1.4、95％Cl 1.0-1.9）和WHO WHO IV期（RR 4.5、95％Cl 2.4-8.5）均与较高的结核病风险相关。此外，使用抗逆转录病毒药物超过180天可将结核病的风险降低70％（RR 0.3，95％Cl 0.2-0.4）。结论：抗逆转录病毒疗法（ART）的使用与降低结核病的风险密切相关感染艾滋病毒的儿童中，因此应纳入艾滋病毒的护理和治疗计划。还应进行旨在改善这些儿童营养和血液学状况的干预措施试验。

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