SEROPREVALENCE OF HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION IN ZAMBIAN CHILDREN WITH TUBERCULOSIS

Descriptions in the medical literature of human immunodeficiency virus type 1 (HIV-1) in children with tuberculosis (TB) are scanty. This st udy determined the seroprevalence of HIV-1 in 237 hospitalized childre n between the ages of 1 month and 14 years with a clinical diagnosis o f TB (125 males and 112 females) and in 242 control children (149 male s and 93 females). The overall HIV-1 seroprevalence rate in patients w ith TB was 37% (88 of 237) compared with 10.7% (26 of 242) among the c ontrol group (P < 0.00001: odds ratio 5.37, 95% confidence interval = 3.21 < 5.37 < 9.47). HIV-1 seropositivity in children with TB ranged f rom 53% (31 of 58) in the 12- to 18-month age group to 14% (9 of 61) i n the 10- to 14-year-olds. The risk of TB attributable to HIV infectio n was 29%. The predominant clinical presentation in both seronegative (84.6%) and seropositive (89.7%) groups was that of pulmonary TB and t here were no significant differences in clinical presentation between the two groups of patients. Only 54.8% of the patients attended follow -up clinics regularly whereas 32% were lost to follow-up within 3 mont hs. Bacillus Calmette-Guerin vaccination coverage was 87.3% among TB p atients and 90.5% in the controls. No significant differences in B. Ca lmette-Guerin vaccination rates between the seronegative and seroposit ive children were seen. Coinfection with HIV and TB in children is now one of the major public health problems in Zambian children.