OBJECTIVE OF THE STUDY: To determine the frequency of HIV in children with disseminated
tuberculosis and tuberculous meningitis in a low HIV prevalence area,
and to study clinical profile of those found HIV positive. STUDY DESIGN: Cross-sectional, descriptive study. PLACE AND DURATION OF STUDY: Jawaharlal Nehru Medical College, Aligarh Muslim University,
Aligarh, India from February 2005 to January 2008.
METHODOLOGY: The study was conducted on 215 children under 14 years of age
with either disseminated tuberculosis or tuberculous meningitis. HIV
infection was diagnosed in accordance with WHO strategy II. In children younger than 18 months, the strategy (to cut down costs) was to screen
first by HIV antibody testing and subject only positive cases to
virological tests. Parents of HIV positive children were also tested for
HIV and counselled. The clinical profile of HIV positive patient was
noted.
RESULTS: The frequency of HIV in all cases of TB was 5.12%, while that in
cases of disseminated tuberculosis was much higher (22%). No case with
isolated tuberculous meningitis was HIV positive. The majority (45.45%)
of patients with HIV were between 1-5 years of age. The mode of
infection in 7 (63.63%) cases was parent to child transmission. Loss of
weight, prolonged fever, pallor, hepato-splenomegaly and oral candidiasis
were the commonest clinical manifestations among HIV positive patients.
CONCLUSION: Clinically directed selective HIV screening in cases of disseminated
tuberculosis can pickup undiagnosed cases of the same in areas with low
prevalence of HIV infection
