Servicio de Pediatría, Hospital Infanta Cristina, Parla, Madrid, Spain.
Pediatr Infect Dis J. 2012 Mar;31(3):278-83. doi: 10.1097/INF.0b013e318239e268.
HIV-infected children are at increased risk of developing mycobacterial disease. The aim of this study was to estimate the change in mycobacterial disease rate in HIV-infected children and adolescents in the highly active antiretroviral therapy (HAART) era.
We carried out a retrospective study. Data were obtained from the records of the minimum basic data set of hospitals in Spain from 1997 to 2008. The epidemiologic trends of mycobacterial diseases were evaluated through the following 3 calendar periods: early-period HAART (1997-1999), midperiod HAART (2000-2002), and late-period HAART (2003-2008).
We analyzed 1307 HIV-infected children and 5228 HIV-uninfected children. HIV-infected children had similar rate of tuberculosis (TB) and nontuberculous mycobacteria (NTM) disease, and they had an overall rate of mycobacterial disease higher than that of HIV-uninfected children (P < 0.001). In HIV-infected children, the highest rates were for pulmonary TB (15/42 [35.7%]) in the TB category and disseminated mycobacterium (9/42 [21.4%]) in the NTM category. The overall rate of mycobacterial disease (events per 1000 HIV-infected children-year) decreased from 1997-1999 to 2003-2008 (5.88-1.63, P = 0.007) and from 2000-2002 to 2003-2008 (4.20-1.63, P = 0.021). Furthermore, the rate of TB decreased from 1997-1999 to 2000-2002 (3.53-0.84, P = 0.016) and from 1997-1999 to 2003-2008 (3.53-1.31, P = 0.030), and the rate of NTM disease decreased from 2000-2002 to 2003-2008 (3.36-0.32, P = 0.002).
The rate of mycobacterial disease decreased among HIV-infected children in the HAART era, but the incidence of mycobacterial disease still remains higher than in the general population.
HIV 感染儿童发生分枝杆菌病的风险增加。本研究的目的是评估高效抗逆转录病毒治疗（HAART）时代 HIV 感染儿童和青少年分枝杆菌病发生率的变化。
我们进行了一项回顾性研究。数据来自西班牙医院最低基本数据集的记录，时间范围为 1997 年至 2008 年。通过以下 3 个日历期评估分枝杆菌病的流行趋势：早期 HAART（1997-1999 年）、中期 HAART（2000-2002 年）和晚期 HAART（2003-2008 年）。
我们分析了 1307 名 HIV 感染儿童和 5228 名 HIV 未感染儿童。HIV 感染儿童的结核病（TB）和非结核分枝杆菌（NTM）疾病发生率相似，且其分枝杆菌病的总发生率高于 HIV 未感染儿童（P < 0.001）。在 HIV 感染儿童中，TB 类别中最常见的是肺结核（15/42 [35.7%]），NTM 类别中最常见的是播散性分枝杆菌（9/42 [21.4%]）。分枝杆菌病总发生率（每 1000 名 HIV 感染儿童年的事件数）从 1997-1999 年到 2003-2008 年下降（5.88-1.63，P = 0.007），从 2000-2002 年到 2003-2008 年下降（4.20-1.63，P = 0.021）。此外，从 1997-1999 年到 2000-2002 年，TB 率下降（3.53-0.84，P = 0.016），从 1997-1999 年到 2003-2008 年，TB 率下降（3.53-1.31，P = 0.030），从 2000-2002 年到 2003-2008 年，NTM 疾病率下降（3.36-0.32，P = 0.002）。
在 HAART 时代，HIV 感染儿童的分枝杆菌病发生率有所下降，但分枝杆菌病的发病率仍高于普通人群。
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