Longitudinal analysis of incidence, risk factors and outcomes among TB/Hiv confected children

Abstract

Tuberculosis (TB) being the most common opportunistic infection in human immunodeficiency virus (HlV)-infected people worldwide has attracted a lot of interest in research. TB manifestations are more severe in HIV-positive children and progression to death is more rapid than in HIV-negative children. TB also hastens the progression of HIV disease by increasing viral replication and reducing CD4 counts further. We performed a retrospective cohort study at a large HIV initiation site-Kcnyatta National Hospital CCC, and use Generalized Estimating Equations to longitudinally identify predictors of incidence and risk factors among children initiated HAART, and in particular to determine the impact of TB co treatment on the outcomes among children with confirmed TB/HIV. Results showed that, for fifty one children who had information on CD4 before TB treatment and after completing TB treatment. The median CD4 percent before was 10% (IQR: 7: 15.6) and 29 (IQR: 20.5: 42.7) after completing TB treatment. Before starting TB treatment, 62.8% of children were immune-suppressed and this proportion reduced to 19.6% after treatment. The difference in the proportion of immune-suppressed children was statistically significant using McNemar test (p-value =0.001)