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Post a Comment Detection, diagnosis and clinical tuberculosis in children with hiv infection
- Authors: Vasilieva E.B.1, Lozovskaya M.E.1, Klochkova L.V.1, Yarovaya I.A.1, Noskova O.M.2
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Affiliations:
- St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
- Saint Petersburg State Healthcare Institution “Children’s City Infectious Diseases Hospital No. 3”
- Issue: Vol 8, No 4 (2017)
- Pages: 19-25
- Section: Articles
- URL: https://journals.rcsi.science/pediatr/article/view/6931
- DOI: https://doi.org/10.17816/PED8419-25
- ID: 6931
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Abstract
The problem of combination of tuberculosis (TB) and HIV remains relevant. Majority of HIV patients are young adults, 90% of which are women of childbearing age, thereby increasing the perinatal HIV transmission rate. In 2014 in Saint Petersburg, >5,000 children with perinatal contact HIV were reported and >300 children were confirmed with HIV infection. We present a comparative analysis of the case histories of 20 children with TB-HIV and 30 with tuberculosis without HIV infection. The analysis identified several cases of delayed diagnosis. In >50% of the cases, the diagnosis of HIV infection was confirmed after 1 year. Four children with HIV infection were diagnosed at school age and connected to suspected cases of tuberculosis. The clinical detection of TB occurs more commonly in children with HIV infection than in those without HIV infection (25% and 5%, respectively). In both groups, tuberculosis of the intrathoracic lymph nodes was predominantly observed; however, generalized forms of TB were also diagnosed in the group with co-infection (25% of the cases). HIV patients often have decreased body mass, low-grade fever, lymphadenopathy, and anemia. Hepatosplenomegaly was equally observed in both groups. More than one third (35%) of patients with co-infection had negative sensitivity to tuberculin, and Diaskintest was positive in 50% of the cases. The prevalence and severity of TB in children with HIV infection correlates with the severity of immunosuppression.
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##article.viewOnOriginalSite##About the authors
Elena B. Vasilieva
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Author for correspondence.
Email: helenchern27@mail.ru
MD, PhD, Associate Professor, Department of TB
Russian Federation, Saint PetersburgMarina E. Lozovskaya
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Email: lozovskaja-marina@rumbler.ru
MD, PhD, Dr Med Sci, Professor, Head, Department of TB
Russian Federation, Saint PetersburgLudmila V. Klochkova
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Email: lklochkova@yahoo.com
MD, PhD, Associate Professor, Department of TB
Russian Federation, Saint PetersburgIulia A. Yarovaya
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Email: julia_yarovaya@mail.ru
MD, PhD, Associate Professor, Department of TB
Russian Federation, Saint PetersburgOlga M. Noskova
Saint Petersburg State Healthcare Institution “Children’s City Infectious Diseases Hospital No. 3”
Email: julia_yarovaya@mail.ru
Tuberculosis Department
Russian Federation, Saint PetersburgReferences
- Белозеров Е.С., Змушко Е.И. ВИЧ-инфекция. 2-е изд. – СПб.: Питер, 2003. – 368 с. [Belozerov ES, Zmushko EI. VICH-infekciya. Saint Petersburg: Piter; 2003. 368 p. (In Russ.)]
- Леванович В.В., Тимченко В.Н., Архипова Ю.А., и др. ВИЧ-инфекция на рубеже веков: Руководство для врачей всех специальностей. – СПб.: Изд-во Н-Л, 2012. – 496 с. [Levanovich VV, Timchenko VN, Arhipova YuA. VICH-infekciya na rubezhe vekov: Rukovodstvo dlya vrachej vsekh special'nostej. Saint Petersburg: Izd-vo N-L; 2012. 496 p. (In Russ.)]
- ВИЧ-инфекция и СПИД. Национальное руководство. Краткое издание / под ред. В.В. Покровского. – М.: ГЭОТАР-Медиа, 2014. – 528 с. [VICH-infekciya i SPID. Nacional'noe rukovodstvo. Kratkoe izdanie / Ed by V.V. Pokrovskiy. Moscow: GEHOTAR-Media; 2014. 528 p. (In Russ.)]
- Васильева Е.Б., Лозовская М.Э., Король О.И., и др. Случай генерализованного туберкулеза у ребенка школьного возраста с поздно выявленной ВИЧ-инфекцией // Туберкулез и болезни легких. – 2015. – № 1. – С. 56–60. [Vasil'eva EB, Lozovskaya ME, Korol' OI, et al. Sluchaj generalizovannogo tuber kuleza u rebenka shkol'nogo vozrasta s pozdno vy yavlennoj VICH-infekciej. Tuberkulez i bolezni legkih. 2015;(1):56-60. (In Russ.)]
- Васильева Е.Б., Клочкова Л.В. Клинико-эпидемиологическая характеристика туберкулеза у де тей раннего возраста // Педиатр. – 2010. – Т. 1. – № 1. – C. 17. [Vasileva EB, Klochkova LV. Kli ni ko-ehpidemiologicheskaya harakteristika tuberkuleza u detej rannego vozrasta. Pediatr. 2010;1(1):17. (In Russ.)]
- Клевно Н.И., Аксенова В.А., Леви Д.Т. Проблемы противотуберкулезной вакцинации ВИЧ-позитивных детей // Туберкулез сегодня: Материалы VIII Российского съезда фтизиатров. – М., 2007. – C. 276–277. [Klev no NI, Aksenova VA, Levi DT. Problemy protivotuberkuleznoj vakcinacii VICH-po zitivnyh detej. (Conference pro ceedings) Tuberkulez segodnya: Materialy VIII Rossijskogo s"ezda ftiziatrov. Moscow; 2007. P. 276-277. (In Russ.)]
- Клевно Н.И. Профилактика туберкулеза у детей, рожденных больными ВИЧ-инфекцией женщинами / Н.И. Клевно, О.П. Фролова, Л.В. Шахмуратова, и др. // Проблемы туберкулеза у больных ВИЧ-инфекцией: Метод. рекомендации. – 2010. – № 10. – С. 8. [Klevno NI, Frolova OP, Shahmuratova LV, et al. Profilaktika tuberkuleza u detej, rozhdennyh bol'nymi VICH-infekciej zhenshchinami. Problemy tuberkuleza u bol'nyh VICH-infekciej. 2010;(10):8. (In Russ.)]
- Клевно Н.И., Аксенова В.А. Проблемы сочетания ВИЧ и туберкулезной инфекции у детей (эпидемио логия, вакцинопрофилактика, диагностика и превентивное лечение) // Пробл. туб. и болезней легких. – 2008. – № 11. – C. 30–34. [Klevno NI, Aksenova VA. Problemy sochetaniya VICH i tuberkuleznoj infekcii u detej (ehpidemiologiya, vakcinoprofilaktika, diagnostika i preventivnoe lechenie). Probl. tub. i boleznej legkih. 2008;(11):30-34. (In Russ.)]
- Лозовская М.Э., Белушков В.Б., Гурина О.П., и др. Сравнительная оценка инновационных тестов в диагностике латентной и активной туберкулезной инфекции у детей // Педиатр. – 2014. – Т. 5. – № 3. – С. 46–50. [Lozovskaya ME, Belushkov VB, Gurina OP, et al. Sravnitelnaya ocenka innovacionnyh testov v diagnostike latentnoj i aktivnoj tuberkuleznoj infekcii u detej. Pediatr. 2014;5(3):46-50. (In Russ.)]
- Садовникова В.Н. Особенности заболеваемости ВИЧ-инфекцией у детей и меры по профилактике перинатальной трансмиссии ВИЧ-инфекции // Педиатрия. Журнал им. Г.Н. Сперанского. – 2010. – С. 14–20. [Sadovnikova VN. Osobennosti zabolevaemosti VICH-infekciej u detej i mery po profilaktike perinatal'noj transmisii VICH-infekcii. Pediatriya. Zhur nal im. G.N. Speranskogo. 2010;14-20. (In Russ.)]
- Федеральные клинические рекомендации по диагностике и лечению туберкулеза у больных ВИЧ-инфекцией. – М.; Тверь: Триада, 2014. – 56 с. [Federal'nye klinicheskie rekomendacii po diagnostike i lecheniyu tuberkuleza u bol'nyh VICH-infekciej. Moscow; Tver': Triada; 2014. 56 p. (In Russ.)]
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