Document 0594
 DOCN  M9480594
 TI    Human immunodeficiency virus type-1 infection in Zambian children with
       tuberculosis: changing seroprevalence and evaluation of a
       thioacetazone-free regimen.
 DT    9410
 AU    Luo C; Chintu C; Bhat G; Raviglione M; Diwan V; DuPont HL; Zumla A;
       Department of Paediatrics, University Teaching Hospital, Lusaka,;
       Zambia.
 SO    Tuber Lung Dis. 1994 Apr;75(2):110-5. Unique Identifier : AIDSLINE
       MED/94305146
 AB    SETTING: This study was conducted at the Department of Paediatrics and
       Child Health, University Teaching Hospital (UTH), in Lusaka, Zambia.
       OBJECTIVES: To monitor the seroprevalence of HIV type-1 in children with
       tuberculosis and to evaluate the response to anti-tuberculosis therapy
       using a thioacetazone-free treatment regimen. DESIGN: A prospective
       cross-sectional study of all consecutive newly diagnosed cases of TB in
       children from 1 month-15 years of age seen at the University Teaching
       Hospital (UTH) in Lusaka, Zambia between 1 October 1991 and 31 May 1992.
       RESULTS: 120 children with a clinical diagnosis of tuberculosis and 167
       controls were enrolled in the study. The overall HIV type-1
       seroprevalence rate in children with tuberculosis was 55.8% (67/120)
       compared to 9.6% (16/167) amongst the control group (P < 0.0001: odds
       ratio = 11.50; 95% CI = 5.99-22.7). Common clinical presentations among
       children with TB were bronchopneumonia (45/162), miliary TB (30/162) and
       tuberculous lymphadenopathy (21/33). There were no significant
       differences in clinical presentation of TB between the HIV-negative and
       HIV-positive groups. The follow-up of those patients with tuberculosis
       was poor, with only 65 patients (55%) returning to the clinic for
       scheduled appointments after discharge. All the 16 patients who died did
       so within 60 days of discharge from hospital; all of them were
       seropositive for HIV. There were no deaths among the HIV-negative group.
       Despite the exclusion of thioacetazone from the treatment regimen,
       cutaneous reactions occurring within 8 weeks of commencing treatment
       were observed in 7 of the 65 (11%) patients, 2 of whom developed fatal
       Stevens-Johnson syndrome. All 7 patients were seropositive for HIV-1.
       CONCLUSIONS: The seroprevalence rate of HIV type-1 among children with
       tuberculosis in Lusaka continues to rise; careful monitoring of anti-TB
       therapy (even in regimens excluding thioacetazone) for potentially
       lethal side effects should be carried out.
 DE    Adolescence  Antibiotics, Combined/THERAPEUTIC USE  Child  Child,
       Preschool  Drug Hypersensitivity  Female  Human  HIV
       Infections/COMPLICATIONS  *HIV Seroprevalence/TRENDS  *HIV-1  Infant
       Isoniazid/THERAPEUTIC USE  Male  Prospective Studies
       Pyrazinamide/THERAPEUTIC USE  Rifampin/THERAPEUTIC USE
       Streptomycin/THERAPEUTIC USE  Support, Non-U.S. Gov't  Support, U.S.
       Gov't, P.H.S.  Treatment Outcome  Tuberculosis,
       Pulmonary/COMPLICATIONS/DRUG THERAPY/*EPIDEMIOLOGY  Zambia/EPIDEMIOLOGY
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).