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TB more likely in infants exposed to HIV-1
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Children of mothers with HIV-1 have an increased risk for tuberculosis, according to study results published in The Pediatric Infectious Disease Journal.
Researchers used the T-Spot.TB interferon-gamma release assay (IGRA; Oxford Immunotec) to test 182 infants of mothers with HIV-1 infection. Mothers received a short course of zidovudine (Retrovir, ViiV Healthcare) at 32 weeks gestation to prevent mother-to-child transmission. Mother and infant pairs were assessed monthly for a year after birth. All infants received the bacille Calmette-Guérin vaccination.
The study results found that 10.9% (95% CI, 6.1-17.7) of infants tested positive for TB infection. Those who tested positive were more likely to have mothers with active TB (OR=15.5; 95% CI, 1.3-184). Infants with a positive assay result were more likely to have prolonged fever during the first 6 months of life. Seven percent of infants had HIV-1.
“Our study points to the need for increased clinical suspicion of TB disease in HIV-1 exposed infants and systematic contact screening to identify infants with TB infection who could benefit from [isoniazid preventive therapy]. In the future, IGRAs may be useful to define infant TB incidence, target provision of IPT, and guide diagnostic decision making. Optimizing cut-offs and determining predictive ability of infant IGRAs for active TB will be important to enhance utility of these assays among HIV-1 exposed infants,” study researcher Lisa M. Cranmer, MD, MPH, of the University of Washington, and colleagues concluded.
Disclosure: The study was supported by an NIH grant.The researchers report no relevant financial disclosures.
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