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Table 2 Summary of key messages related to TB/HIV co-infection in children

From: Tuberculosis and pneumonia in HIV-infected children: an overview

HIV-infected and exposed uninfected (HEU) children are at high risk of developing TB

High likelihood of household TB exposure early in life; disproportionate TB/HIV burden in young mothers

Advanced disease, low CD4 count and malnutrition are additional risk factors

All children with HIV must be regularly screened for TB exposure and disease

BCG vaccination is contra-indicated in children known to be HIV-infected

Strategies to prevent TB

High community penetration of adult ART will reduce TB transmission in communities

Universal early ART initiation in all HIV-infected

Appropriate use of INH preventative therapy

Active TB Case finding

Infection prevention and control strategies

History of contact

Early diagnosis of TB

Symptoms can overlap with other opportunistic infections

Pulmonary and extrapulmonary disease possible

Pulmonary TB can present like acute pneumonia

A positive TST (≥5 mm) or IGRA confirms TB infection but not disease

CXR is important; HIV-infected children more likely to have alveolar opacification and lung cavities

Collect specimens for culture and Xpert MTB/RIF® as appropriate

Treating TB/HIV co-infection

Use appropriate/standard TB treatment regimen

Adapt the ART regimen and dosing

Support adherence

Monitor for efficacy and side effects

  1. HIV human immunodeficiency virus, TB tuberculosis, ART antiretroviral treatment, INH isoniazid, TST tuberculin skin test, IGRA interferon gamma release assay, CXR chest radiograph