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HIV and Tuberculosis in Children

  • Tonya Arscott-Mills
  • Ben Marais
  • Andrew Steenhoff
Chapter

Abstract

TB/HIV co-infection poses a formidable challenge. The added complications of age related immune differences affect the presentation and evaluation in children. Young immune immature children have a naturally increased risk of progression to active TB after primary M. tuberculosis infection, which is compounded by HIV co-infection. The pauci-bacillary nature of their disease and difficulties in obtaining good specimens from young children complicates diagnostic evaluations. A TB diagnosis in an HIV-infected child relies on a detailed exposure history, careful clinical assessment and use of all available evidence indicating TB infection and/or disease. However, once diagnosed children usually respond well to therapy, although drug-drug interactions, pill burdens, social circumstances and personal age-appropriate support must be considered in the care of these children.

Keywords

Pediatric TB/HIV Childhood TB/HIV Mycobacterium tuberculosis Tuberculosis Epidemiology Diagnosis Treatment Prevention Extrapulmonary TB Pediatrics HIV infection Anti-tuberulous therapy Isoniazid Rifampin Ethambutol Pyrazinamide Anti-retroviral therapy Point-of-care Directly observed therapy Drug-resistance 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Tonya Arscott-Mills
    • 1
    • 2
  • Ben Marais
    • 3
  • Andrew Steenhoff
    • 1
    • 2
  1. 1.Department of PediatricsPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Children’s Hospital of Philadelphia Global Health CenterPhiladelphiaUSA
  3. 3.The Children’s Hospital at Westmead Clinical SchoolUniversity of SydneySydneyAustralia

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