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M9480594.TXT
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1994-08-20
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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).