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Abstract
We describe active tuberculosis among two children harboring Multi-Drug Resistant HIV (MDRHIV) in Cameroon: A male of age 13, TB-treated in 2009, diagnosed with MDRHIV on antiretroviral therapy intensification. A male of age 15, admitted for intensive care with an atypical persistent pneumonia and weight loss, harbouring MDRHIV with drug treatment failure to all antiretrovirals available nationwide. Specific investigations and guidelines would be relevant.
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References
- . Getahun H, Gunneberg C, Granich R, and Nunn P: HIV infection associated tuberculosis: the epidemiology and the response. Clin. Infect. Dis. 50(Suppl. 3):S201–S207, 2010.
- Global Tuberculosis Control: WHO Report 2010 [WHO website]. Available at: http://whqlibdoc.who.int/publications/2010/9789241564069_eng
- Sun L, Xiao J, Miao Q et al: Interferon gamma release assay in diagnosis of pediatric tuberculosis: a meta-analysis. FEMS Immunology & Medical Microbiology. 63(2): 165-173, 2011.
- Hesseling AC, Cotton MF, Jenning T, et al: High incidence of tuberculosis among HIV infected infants. South African population-based study. Clin Infect Dis. 48:108-114, 2009.
- Schneider T, Jahn HU, Schmidt W, Riecken EO, Zeitz M and Ullrich R . Loss of CD4 T lymphocytes in patients infected with human immunodeficiency virus type 1 is more pronounced in the duodenal mucosa than in the peripheral blood. Berlin Diarrhea/Wasting Syndrome Study Group. Gut. 37:524–529, 1995.
- Veazey RS, Marx PA, and Lackner AA. The mucosal immune system: primary target for HIV infection and AIDS. Trends Immunol. 22:626–633, 2001.
- Anonymous. Antiretroviral therapy and medical management of pediatric HIV infection and 1997 USPHS/IDSA report on the prevention of opportunistic infections in persons infected with human immunodeficiency virus. Pediatrics. 102(4 Pt. 2):999–1085, 1998.
- Bucy RP, and Kilby JM. Perspectives on inducing efficient immune control of HIV-1 replication—a new goal for HIV therapeutics? AIDS. 15(Suppl. 2):S36–S42: 2001.
- Merchant RH, and Quadir ZA. Management of opportunistic infections in pediatric HIV. Indian J. Pediatr. 69:973–977, 2002.
- Lawn SD, Myer L, Edwards D, Bekker LG, and Wood R. Short-term and long-term risk of tuberculosis associated with CD4 cell recovery during antiretroviral therapy in South Africa. AIDS. 23:1717–1725, 2009.
- Kizza HM, Rodriguez B, Quinones-Mateu M et al. Persistent replication of human immunodeficiency virus type 1 despite treatment of pulmonary tuberculosis in dually infected subjects. Clin. Diagn. Lab. Immunol. 12:1298–1304, 2005.
- Diedirch CR and Flynn JL. HIV-1/Mycobacterium tuberculosis coinfection immunology: How Does HIV-1 exacerbate tuberculosis? .Infection and Immunity. 79: 1407–1417, 2011.
- Toossi Z, Jonhson JL, Kanost RA et al. Increased replication of HIV-1 at sites of Mycobacterium tuberculosis infection: potential mechanisms of viral activation. J. Acquir. Immune Defic. Syndr. 28:1–8, 2001.
References
. Getahun H, Gunneberg C, Granich R, and Nunn P: HIV infection associated tuberculosis: the epidemiology and the response. Clin. Infect. Dis. 50(Suppl. 3):S201–S207, 2010.
Global Tuberculosis Control: WHO Report 2010 [WHO website]. Available at: http://whqlibdoc.who.int/publications/2010/9789241564069_eng
Sun L, Xiao J, Miao Q et al: Interferon gamma release assay in diagnosis of pediatric tuberculosis: a meta-analysis. FEMS Immunology & Medical Microbiology. 63(2): 165-173, 2011.
Hesseling AC, Cotton MF, Jenning T, et al: High incidence of tuberculosis among HIV infected infants. South African population-based study. Clin Infect Dis. 48:108-114, 2009.
Schneider T, Jahn HU, Schmidt W, Riecken EO, Zeitz M and Ullrich R . Loss of CD4 T lymphocytes in patients infected with human immunodeficiency virus type 1 is more pronounced in the duodenal mucosa than in the peripheral blood. Berlin Diarrhea/Wasting Syndrome Study Group. Gut. 37:524–529, 1995.
Veazey RS, Marx PA, and Lackner AA. The mucosal immune system: primary target for HIV infection and AIDS. Trends Immunol. 22:626–633, 2001.
Anonymous. Antiretroviral therapy and medical management of pediatric HIV infection and 1997 USPHS/IDSA report on the prevention of opportunistic infections in persons infected with human immunodeficiency virus. Pediatrics. 102(4 Pt. 2):999–1085, 1998.
Bucy RP, and Kilby JM. Perspectives on inducing efficient immune control of HIV-1 replication—a new goal for HIV therapeutics? AIDS. 15(Suppl. 2):S36–S42: 2001.
Merchant RH, and Quadir ZA. Management of opportunistic infections in pediatric HIV. Indian J. Pediatr. 69:973–977, 2002.
Lawn SD, Myer L, Edwards D, Bekker LG, and Wood R. Short-term and long-term risk of tuberculosis associated with CD4 cell recovery during antiretroviral therapy in South Africa. AIDS. 23:1717–1725, 2009.
Kizza HM, Rodriguez B, Quinones-Mateu M et al. Persistent replication of human immunodeficiency virus type 1 despite treatment of pulmonary tuberculosis in dually infected subjects. Clin. Diagn. Lab. Immunol. 12:1298–1304, 2005.
Diedirch CR and Flynn JL. HIV-1/Mycobacterium tuberculosis coinfection immunology: How Does HIV-1 exacerbate tuberculosis? .Infection and Immunity. 79: 1407–1417, 2011.
Toossi Z, Jonhson JL, Kanost RA et al. Increased replication of HIV-1 at sites of Mycobacterium tuberculosis infection: potential mechanisms of viral activation. J. Acquir. Immune Defic. Syndr. 28:1–8, 2001.