Int J Tuberc Lung Dis. 2006 Dec;10(12):1331-6.
Human immunodeficiency virus (HIV) infected children are at risk of a range of lung diseases related to HIV infection, including tuberculosis (TB). As in non-HIV-infected children, the presence of three or more of the following four features strongly suggests the diagnosis of TB: 1) chronic symptoms suggestive of TB; 2) physical changes highly suggestive of TB; 3) a positive tuberculin skin test; 4) a chest radiograph suggestive of TB. Every effort must be made to expedite the process of making the diagnosis, as TB may be rapidly progressive in HIV-infected children. As many children who present with chronic symptoms suggestive of TB may not have been tested for HIV infection, in high HIV prevalence settings (and in all settings where HIV is suspected in a child) children and their families should be offered HIV counselling and testing as part of a full TB work-up. Most current international guidelines recommend that TB in HIV-infected children, as in non-HIV-infected children, should be treated with a 6-month regimen containing rifampicin throughout. All HIV-infected children with advanced immunosuppression, including many with TB, should receive cotrimoxazole prophylaxis. Although the optimal timing for the initiation of antiretroviral treatment (ART) during TB treatment is not known, the decision to initiate ART should take into consideration the degree of immune suppression and the child's progress during TB treatment.
感染人类免疫缺陷病毒（HIV）的儿童有患一系列与HIV感染相关肺部疾病的风险，包括结核病（TB）。与未感染HIV的儿童一样，以下四项特征中出现三项或更多项强烈提示结核病诊断：1）提示结核病的慢性症状；2）高度提示结核病的体格改变；3）结核菌素皮肤试验阳性；4）提示结核病的胸部X光片。必须尽一切努力加快诊断进程，因为结核病在感染HIV的儿童中可能迅速进展。由于许多出现提示结核病慢性症状的儿童可能未接受过HIV感染检测，在HIV高流行地区（以及所有怀疑儿童感染HIV的地区），应在全面结核病检查过程中为儿童及其家人提供HIV咨询和检测。目前大多数国际指南建议，感染HIV的儿童中的结核病，与未感染HIV的儿童一样，应采用全程含利福平的6个月治疗方案。所有免疫抑制严重的感染HIV儿童，包括许多患有结核病的儿童，都应接受复方新诺明预防治疗。虽然在结核病治疗期间开始抗逆转录病毒治疗（ART）的最佳时机尚不清楚，但开始ART的决定应考虑免疫抑制程度和儿童在结核病治疗期间的进展情况。
