EVIDENCE FOR TUBERCULOUS INFECTION IN ROMANIAN HIV-POSITIVE CHILDREN BY ENZYME-LINKED-IMMUNOSORBENT-ASSAY

The pandemic spread of tuberculosis (TB) and human immunodeficiency vi rus (HIV) represents a serious world problem. The diagnosis of TB in d eveloping countries remains difficult, particularly in patients with c oncomitant HIV infection. Anergia to tuberculin frequently occurs in H IV-positive patients with pulmonary or extrapulmonary disease, and rad iographic images are atypical or nondiagnostic. Children are often in an even more unfavorable situation: they cannot expectorate, and the b iological samples required for bacteriological examination and culture are more difficult to obtain. We present in this work the correlation between the presence of serum antimycobacterial antibodies [as demons trated by an in-house enzyme-linked immunosorbent assay (ELISA)] in 41 out of 279 HIV-infected children, and clinical, bacteriological, radi ological, and pathological data that support the diagnosis of TB in th ese children. The prevalence of antimycobacterial antibodies in our gr oup of HIV-positive children was 23.3%. In only 4 of the total cases i nvestigated could the diagnosis of TB not be supported by the results of standard tests for TB. The control group showed an insignificant in terference from bacillus Calmette-Guerin (BCG) vaccination.