Detection, diagnosis and clinical tuberculosis in children with hiv infection

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Abstract


The problem of combination of TB and HIV remains relevant. The majority of patients – young adults, 90% of women with HIV of childbearing age, increasing numbers of children with perinatal contact with HIV. In Saint Petersburg for 2014 born more than 5 000 children with perinatal contact with HIV infection, more than 300 children have a confirmed diagnosis of HIV infection. A comparative analysis of case histories of 20 children with a combination of TB-HIV and 30 children with tuberculosis without HIV infection. Analysis of results showed that there are cases of late diagnosis. So, more than half of the cases, the diagnosis of HIV infection was confirmed after 1 year. 4 children with HIV infection diagnosed at school age when examined in connection with suspected tuberculosis. Detection of TB in children with HIV infection more frequently than children without HIV infection, is clinical method (25% and 5%, respectively). In structure of clinical forms of tuberculosis in both groups was dominated by tuberculosis of intrathoracic lymph nodes, but in the group of children with CO-infection are often recorded generalized forms (25% of cases). The clinical picture in patients with HIV often registered a decrease of body weight, subfebrilitet, polilymphadenopathy, anemia; hepatosplenomegaly was detected in both groups with equal frequency. More than a third (35%) patients with CO-infection was determined by negative sensitivity to tuberculin, Diaskintest in 50% of cases. The prevalence and severity of TB in children with HIV infection correlates with the degree of immunosuppression.


Elena B. Vasilieva

Author for correspondence.
helenchern27@mail.ru
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation, Saint Petersburg

MD, PhD, Associate Professor, Department of TB

Marina E. Lozovskaya

lozovskaja-marina@rumbler.ru
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation, Saint Petersburg

MD, PhD, Dr Med Sci, Professor, Head, Department of TB

Ludmila V. Klochkova

lklochkova@yahoo.com
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation, Saint Petersburg

MD, PhD, Associate Professor, Department of TB

Iulia A. Yarovaya

julia_yarovaya@mail.ru
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation, Saint Petersburg

MD, PhD, Associate Professor, Department of TB

Olga M. Noskova

julia_yarovaya@mail.ru
Saint Petersburg State Healthcare Institution “Children’s City Infectious Diseases Hospital No. 3”
Russian Federation, Saint Petersburg

Tuberculosis Department

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Copyright (c) 2017 Vasilieva E.B., Lozovskaya M.E., Klochkova L.V., Yarovaya I.A., Noskova O.M.

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