Tuberculosis in Human Immunodeficiency Virus—Infected Children

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Abstract
• Objective. —To study the epidemiologic and clinical features of infection withMycobacterium tuberculosisin human immunodeficiency virus (HIV)–infected children and their families. Patients and Clinical Setting. —Sixty families of children with HIV infection, children of HIV indeterminate status, and seroreverters underwent follow-up in a comprehensive multidisciplinary program for children and families. Methods. —Infection withM tuberculosiswas diagnosed based on a positive Mantoux test result or a positive culture. Results. —Mycobacterium tuberculosisinfection was diagnosed in seven children (three infected with HIV, three seroreverters, and one uninfected sibling of an infected child) from four families (6%). All infections were detected in the period from March 1990 through January 1992. Six of seven children had a history of exposure toM tuberculosisin an HIV-infected adult (parent) who was an intravenous drug user, homeless, and/or noncompliant with the medical regimen. All HIV-infected children and one seroreverter had pulmonary tuberculosis. One child died of complications of tuberculosis and HIV infection. TheM tuberculosisisolated from this child was resistant to isoniazid, rifampin, and streptomycin sulfate. Conclusions. —Tuberculosis is a growing problem among inner-city children born to HIV-infected parents. Children infected with HIV in this study had symptomatic and severe disease with tuberculosis, which reflected the drug susceptibility pattern ofM tuberculosisseen in our community. (AJDC. 1993;147:320-324)