Characteristics and mortality of children living with HIV/TB coinfection in a tertiary hospital in a resource-limited setting

资源匮乏地区三级医院中艾滋病毒/结核病合并感染儿童的特征和死亡率

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Abstract

BACKGROUND: In Indonesia, children living with human immunodeficiency virus (HIV) face a heightened risk of tuberculosis (TB) coinfection. This study aims to explore the clinical characteristics and mortality of children with HIV/TB coinfection. METHODS: A retrospective observational study was conducted on children diagnosed with HIV/TB coinfection and treated between 2017 and 2021 in Dr. M. Djamil Central Hospital, Padang City, Indonesia. RESULTS: Twenty-seven children were diagnosed with HIV/TB coinfection. Most children were male, aged five years or older, and resided in rural areas. All patients exhibited HIV clinical stage III or IV, with a median (IQR) CD4 count of 49 (18-534) cells/mm(3). The most frequently reported clinical manifestations were fever, cough, and growth/developmental delay. Four patients died while being treated in the hospital, resulting in a mortality rate of 14.8%. In crude analysis, severe anemia (p = 0.025) and pneumonia (p = 0.012) were significantly associated with mortality. CONCLUSIONS: This study highlights the considerable mortality risk among children living with HIV/TB coinfection, particularly emphasizing the significance of addressing severe anemia and pneumonia as contributing factors.

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