Ramírez-Cardich María E, Kawai Vivian, Oberhelman Richard A, Bautista Christian T, Castillo María E, Gilman Robert H
Asociación Benéfica Proyectos en Informática, Salud, Medicina, y Agricultura (A.B. PRISMA), Lima, Peru.
Int J Infect Dis. 2006 Jul;10(4):278-81. doi: 10.1016/j.ijid.2005.06.012. Epub 2006 Mar 15.
In developing countries, tuberculosis (TB) is responsible for almost 250,000 deaths among children yearly. Active TB in children with human immunodeficiency virus (HIV) infection is difficult to diagnose and progresses rapidly to death. The aim of this preliminary study was to investigate the prevalence and clinical correlates of TB-related illness among HIV-infected children admitted to an infectious diseases ward in Peru, a country where TB is highly endemic.
Forty-seven HIV-infected children admitted for a suspected infectious process in a Peruvian hospital were investigated for evidence of clinical tuberculosis by auramine stain, culture, and polymerase chain reaction (PCR) of clinical specimens.
Eight children (17%) had evidence of tuberculosis, including five with positive cultures and three with positive PCR tests only. Weight loss was the only feature associated with a positive test for tuberculosis. Radiological changes were very common in both TB-positive and TB-negative groups and these changes were not useful to identify TB-positive cases.
Weight loss may be used to identify high-risk HIV positive children who require more aggressive evaluation for tuberculosis. Radiological changes were common in both TB-positive and TB-negative groups.
在发展中国家，结核病每年导致近25万名儿童死亡。感染人类免疫缺陷病毒（HIV）的儿童患活动性结核病难以诊断，且病情迅速发展至死亡。本初步研究的目的是调查在结核病高度流行的秘鲁，入住传染病病房的HIV感染儿童中结核病相关疾病的患病率及其临床相关因素。
对秘鲁一家医院收治的47名因疑似感染性疾病而入院的HIV感染儿童，通过对临床标本进行金胺染色、培养及聚合酶链反应（PCR）来调查是否存在临床结核病证据。
8名儿童（17%）有结核病证据，其中5名培养结果呈阳性，3名仅PCR检测呈阳性。体重减轻是与结核病检测呈阳性相关的唯一特征。影像学改变在结核病阳性组和阴性组中都很常见，这些改变对识别结核病阳性病例并无帮助。
体重减轻可用于识别需要更积极评估是否患有结核病的高危HIV阳性儿童。影像学改变在结核病阳性组和阴性组中都很常见。
