Human immunodeficiency virus infection in children with tuberculosis in Santo Domingo, Dominican Republic: prevalence, clinical findings, and response to antituberculosis treatment

J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Oct 1;13(2):155-9. doi: 10.1097/00042560-199610010-00006.


We studied human immunodeficiency virus (HIV)-seroprevalence among children with clinically diagnosed tuberculosis (TB) and compared the clinical features and response to short-term anti-TB therapy of children with and without HIV infection in Santo Domingo, Dominican Republic. Children aged 18-59 months with new-onset, clinically diagnosed TB were tested for HIV antibodies, their clinical features were recorded and their response to a standard 6-month regimen of daily isoniazid and rifampicin with daily streptomycin and pyrazinamide for the first 2 months was assessed. To increase the number of HIV-infected children with TB available for study, we also included children previously known to be HIV infected who developed new-onset TB. Eleven (5.8%) of 189 consecutively enrolled children with clinically diagnosed TB were HIV infected. Fifteen other children with previously documented HIV infection and new-onset TB were available for study, yielding 26 HIV-positive and 178 HIV-negative children with TB. Of these 204 children with clinically diagnosed TB, 25 HIV-positive and 156 HIV-negative children were successfully followed for 6 months or until death. The proportion of HIV-positive children who failed treatment was 6 (29%) of 21 as compared with only 5 (3%) of 156 HIV-negative children [relative risk = 8.9; 95% confidence interval (CI) 2.9, 26.6; p = 0.0004]. HIV-infected children with clinically diagnosed TB are substantially more likely to fail standard treatment for TB than are HIV-uninfected children. If standard treatment regimens are used in such children, response to treatment must be monitored very closely and appropriate changes in the regimen must be made expeditiously.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS Serodiagnosis
  • Antibiotics, Antitubercular / therapeutic use*
  • Antitubercular Agents / therapeutic use*
  • Child, Preschool
  • Dominican Republic / epidemiology
  • Female
  • HIV Infections / complications*
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology
  • HIV Seroprevalence / trends
  • Humans
  • Infant
  • Isoniazid / therapeutic use*
  • Male
  • Prevalence
  • Pyrazinamide / therapeutic use*
  • Rifampin / therapeutic use*
  • Streptomycin / therapeutic use*
  • Tuberculosis, Pulmonary / complications*
  • Tuberculosis, Pulmonary / drug therapy*
  • Tuberculosis, Pulmonary / epidemiology


  • Antibiotics, Antitubercular
  • Antitubercular Agents
  • Pyrazinamide
  • Isoniazid
  • Rifampin
  • Streptomycin