Chintu C, Bhat G, Luo C, Raviglione M, Diwan V, Dupont H L, Zumla A
Department of Paediatrics, University Teaching Hospital, Lusaka, Zambia.
Pediatr Infect Dis J. 1993 Jun;12(6):499-504. doi: 10.1097/00006454-199306000-00008.
Descriptions in the medical literature of human immunodeficiency virus type 1 (HIV-1) in children with tuberculosis (TB) are scanty. This study determined the seroprevalence of HIV-1 in 237 hospitalized children between the ages of 1 month and 14 years with a clinical diagnosis of TB (125 males and 112 females) and in 242 control children (149 males and 93 females). The overall HIV-1 seroprevalence rate in patients with TB was 37% (88 of 237) compared with 10.7% (26 of 242) among the control group (P < 0.00001: odds ratio 5.37, 95% confidence interval = 3.21 < 5.37 < 9.47). HIV-1 seropositivity in children with TB ranged from 53% (31 of 58) in the 12- to 18-month age group to 14% (9 of 61) in the 10- to 14-year-olds. The risk of TB attributable to HIV infection was 29%. The predominant clinical presentation in both seronegative (84.6%) and seropositive (89.7%) groups was that of pulmonary TB and there were no significant differences in clinical presentation between the two groups of patients. Only 54.8% of the patients attended follow-up clinics regularly whereas 32% were lost to follow-up within 3 months. Bacillus Calmette-Guérin vaccination coverage was 87.3% among TB patients and 90.5% in the controls. No significant differences in B. Calmette-Guérin vaccination rates between the seronegative and seropositive children were seen. Coinfection with HIV and TB in children is now one of the major public health problems in Zambian children.
医学文献中关于患有结核病（TB）儿童的人类免疫缺陷病毒1型（HIV-1）的描述很少。本研究确定了237名年龄在1个月至14岁之间、临床诊断为结核病的住院儿童（125名男性和112名女性）以及242名对照儿童（149名男性和93名女性）中HIV-1的血清阳性率。结核病患者中HIV-1的总体血清阳性率为37%（237例中的88例），而对照组为10.7%（242例中的26例）（P<0.00001：比值比5.37，95%置信区间=3.21<5.37<9.47）。患有结核病儿童的HIV-1血清阳性率在12至18个月年龄组为53%（58例中的31例），在10至14岁儿童中为14%（61例中的9例）。由HIV感染导致结核病的风险为29%。血清阴性组（84.6%）和血清阳性组（89.7%）中最主要的临床表现均为肺结核，两组患者的临床表现无显著差异。只有54.8%的患者定期前往随访门诊，而32%的患者在3个月内失访。卡介苗接种覆盖率在结核病患者中为87.3%，在对照组中为90.5%。血清阴性和血清阳性儿童之间的卡介苗接种率未见显著差异。儿童中HIV与TB的合并感染现在是赞比亚儿童面临的主要公共卫生问题之一。
