HIV-positive Infants Are Likely to Develop TB

A new study out of Cape Town, South Africa published in the Journal of Clinical Infectious Diseases has found that HIV-positive infants are about 20 times more likely to develop tuberculosis (TB) than infants without HIV.

Researchers from the Desmond Tutu TB Center at Stellenbosch University in South Africa, led by Anneke Hesseling, examined the incidence of HIV and TB among infants between 2004 and 2006. Researchers reported finding 245 infants with TB, and they estimated that the overall incidence of TB was 1,596 cases per 100,000 among HIV-positive infants and 65.9 cases per 100,000 for infants without HIV.

The research also analyzed data from incidences of three types of TB. Pulmonary, extrapulmonary, and disseminated tuberculosis cases were estimated by examining prospective representative hospital surveillance data of the annual number of culture-confirmed tuberculosis cases among infants.

The total number of HIV-infected and HIV-uninfected infants was calculated using population-based estimates of the total number of live infants and the annual rates of maternal HIV prevalence and vertical HIV transmission. HIV-infected infants were at a 24.1-fold higher risk of pulmonary TB and a 17.1-fold higher risk of disseminated TB.

According to the abstract of the article in Clinical Infectious Diseases, the study highlights the prevalence of the TB disease burden among HIV-infected infants and provides population-based data of tuberculosis among HIV-infected infants that can be used for comparison studies. Hesseling said that the higher incidence of TB among HIV-positive infants could be explained by an increased exposure to TB, a weaker immune response associated with HIV, and reduced efficacy of the bacille Calmette-Guérin vaccine.

Additionally, Hesseling added that one way to reduce the incidence of TB among infants born to HIV-positive women is to implement TB testing among pregnant women. She also suggested routine HIV testing among infants with TB, prophylactic treatment for TB, improved HIV treatment access, and newer vaccines as methods to curb the spread of TB.