Bacteriologically confirmed tuberculosis in HIV-infected infants: disease spectrum and survival

Int J Tuberc Lung Dis. 2011 Jun;15(6):770-5. doi: 10.5588/ijtld.10.0501.


Background: The human immunodeficiency virus (HIV) has resulted in epidemiological shifts with an emergence of tuberculosis (TB) amongst HIV-infected women and infants. There are limited data on the TB disease spectrum and outcome amongst HIV-infected infants.

Objectives: We describe the clinical characteristics, treatment and survival of HIV-infected infants with culture-confirmed TB.

Methods: This retrospective hospital-based study from Cape Town, South Africa, used routine laboratory-based surveillance among infants diagnosed with culture-confirmed TB from 1 January 2004 to 31 December 2006. Folder and chest radiographic review were completed and vitality status established. TB was classified as pulmonary, extra-pulmonary or disseminated disease.

Results: Of 52 infants, 37 (71.1%) had pulmonary, 2 (3.9%) extra-pulmonary only, 7 (13.5%) pulmonary and extra-pulmonary and 6 (11.5%) disseminated TB. Forty-six (88.5%) were started anti-tuberculosis therapy; 37 (71.2%) received antiretroviral therapy (ART) and 17 (32.7%) died, 10 (19.2%) of whom never started ART. HIV stage 4 disease was associated with death. TB treatment outcome was poorly documented.

Conclusions: TB is associated with advanced HIV disease and high mortality in HIV-infected infants. Missed opportunities for initiation of ART were frequent. Although the effects of young age, TB disease spectrum and HIV co-infection are difficult to distinguish, our findings support the initiation of early ART in HIV-infected infants with TB.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / microbiology*
  • AIDS-Related Opportunistic Infections / mortality*
  • Anti-Retroviral Agents / therapeutic use
  • Antitubercular Agents / therapeutic use
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mycobacterium tuberculosis / isolation & purification
  • Polymerase Chain Reaction
  • Retrospective Studies
  • Severity of Illness Index
  • South Africa / epidemiology
  • Sputum / microbiology
  • Survival Analysis
  • Tuberculosis / complications*
  • Tuberculosis / drug therapy
  • Tuberculosis / mortality*
  • Tuberculosis / prevention & control
  • Tuberculosis Vaccines / administration & dosage


  • Anti-Retroviral Agents
  • Antitubercular Agents
  • Tuberculosis Vaccines