Pefura Yone E W, Evouna Mbarga A, Kuaban C
Service de pneumologie, hôpital Jamot de Yaoundé, BP 4021 Yaoundé, Cameroun.
Rev Mal Respir. 2012 Nov;29(9):1095-103. doi: 10.1016/j.rmr.2012.05.017. Epub 2012 Jul 18.
To define the prevalence of HIV infection in childhood tuberculosis and investigate its impact on the clinical presentation, radiographic findings and outcomes among children suffering from tuberculosis in Yaounde.
The medical records of 101 children aged less than 15years, hospitalized with tuberculosis in the chest clinic of the Yaounde Jamot Hospital between January 2005 and June 2010, were retrospectively reviewed.
Twenty-five (24.8%) of the 101 patients were HIV positive. The occurrence of concomitant intrathoracic and extrathoracic tuberculosis was more frequently observed in HIV infected children (P=0.021). Parenchymal pulmonary lesions were bilateral in 20 (90.9%) of the HIV infected children against 31 (56.1%) in the non-infected children (P=0.003). Cavitating lesions were present in 49.1% of the cases in HIV negative group versus 13.6% in HIV positive group (P=0.004), but sub-group analysis restricted to those with confirmed tuberculosis no longer showed a significant difference. The success rate of treatment was 78.9% among HIV negative patients and 56% among HIV positive patients (P=0.024).
HIV infection modifies the clinical presentation and radiographic features of tuberculosis in children. The treatment success rate is lower in HIV positive children, indicating a stricter medical supervision of these children and more targeted education of their parents.
确定儿童结核病中艾滋病毒感染的患病率，并调查其对雅温得结核病患儿临床表现、影像学表现及治疗结果的影响。
回顾性分析2005年1月至2010年6月在雅温得贾莫特医院胸科门诊住院的101例15岁以下结核病患儿的病历。
101例患者中有25例（24.8%）艾滋病毒呈阳性。艾滋病毒感染儿童更常出现胸内和胸外结核病合并发生的情况（P = 0.021）。20例（90.9%）艾滋病毒感染儿童的实质性肺部病变为双侧性，而非感染儿童中这一比例为31例（56.1%）（P = 0.003）。艾滋病毒阴性组49.1%的病例有空洞性病变，而艾滋病毒阳性组为13.6%（P = 0.004），但仅限于确诊结核病患者的亚组分析不再显示有显著差异。艾滋病毒阴性患者的治疗成功率为78.9%，艾滋病毒阳性患者为56%（P = 0.024）。
艾滋病毒感染改变了儿童结核病的临床表现和影像学特征。艾滋病毒阳性儿童的治疗成功率较低，这表明对这些儿童需要更严格的医疗监管，并对其家长进行更有针对性的教育。
