Virologic and immunologic status of children with HIV-TB co-infections

  • Djatnika Setiabudi Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia https://orcid.org/0000-0002-7488-4377
  • Citra Cesilia Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia https://orcid.org/0000-0001-8914-0285
  • Almira Aliyannissa Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital https://orcid.org/0000-0002-9479-7369
  • Heda Melinda Nataprawira Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia https://orcid.org/0000-0001-8079-6544
DOI: https://doi.org/10.14238/pi61.2.2021.94-9
Keywords: HIV, children, Indonesia, poor outcome, TB co-infection

Abstract

Background Studies about virologic and immunologic status of HIV children are lacking. Tuberculosis (TB) is the most common opportunistic infection in HIV patients and co-infection is associated with much worse prognosis.

Objective To describe the virologic and immunologic status of patients  with HIV and TB co-infection, before and after HIV and TB treatment.

Methods A prospective study was conducted in HIV  co-infected with TB patients in an Indonesian tertiary hospital between November 2016—December 2018. Viral load and CD4 levels were performed at diagnosis and after 6 months of HIV and TB treatment.

Results Of 44 children hospitalized due to HIV, 15 newly diagnosed HIV cases had TB co-infection. Thirteen were included as subjects. Most patients (10/13) were under 5 years of age, with similar female and male proportions (7/13 vs. 6/13, respectively). All were diagnosed with stage 4 HIV. Six patients had respiratory problems at admission. First examinations revealed severe immunodeficiency (CD4+ <20%) in all patients, and high viral loads (>105 copies/mL) in most (9/13) patients. Despite good compliance to medications, 8/13 patients died before the sixth month follow-up. Deterioration of virologic and immunologic status was seen in 3/4 of the followed-up patients.

Conclusion  Children with HIV-TB coinfections have severe immunodeficiency and high viral loads. Most such patients die before 6 months, while survivors experience virologic and immunologic status deterioration. Future study must take into account for HIV drug resistance investigation.

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Published
2021-03-16
How to Cite
1.
Setiabudi D, Cesilia C, Aliyannissa A, Nataprawira H. Virologic and immunologic status of children with HIV-TB co-infections. PI [Internet]. 16Mar.2021 [cited 19Apr.2024];61(2):94-. Available from: https://www.paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2518
Issue
Vol 61 No 2 (2021): March 2021
Section
Infection & Tropical Pediatrics

Copyright (c) 2021 Djatnika Setiabudi, Citra Cesilia, Almira Aliyannissa, Heda Melinda Nataprawira

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Received 2020-11-04
Accepted 2021-03-16
Published 2021-03-16