@article{fdi:010071418,
  title = {{I}ncidence of tuberculosis and associated mortality in a cohort of human immunodeficiency virus-infected children initiating antiretroviral therapy},
  author = {{S}alvadori, {N}icolas and {N}go-{G}iang-{H}uong, {N}icole and {D}uclercq, {C}. and {K}anjanavanit, {S}. and {N}gampiyaskul, {C}. and {T}echakunakorn, {P}. and {P}uangsombat, {A}. and {F}igoni, {J}. and {M}ary, {J}. {Y}. and {C}ollins, {I}. {J}. and {C}ressey, {T}. {R}. and {L}e {C}oeur, {S}. and {S}irirungsi, {W}. and {L}allemant, {M}arc and {M}c{I}ntosh, {K}. and {J}ourdain, {G}onzague},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {W}e assessed the incidence of tuberculosis, risk factors for tuberculosis, and the contribution of tuberculosis on mortality in a large cohort of human immunodeficiency virus ({HIV})-infected children <15 years of age initiating first-line antiretroviral therapy ({ART}) between 1999 and 2012 in {T}hailand, one of the 22 high tuberculosis burden countries. {M}ethods. {A} physician reviewed and classified tuberculosis cases. {I}ncidence was the number of children with incident tuberculosis, defined as a first or recurrent tuberculosis diagnosis >30 days after {ART} initiation, divided by the total person-years of follow-up ({PYFU}). {R}isk factors for incident tuberculosis were identified using {F}ine and {G}ray's competing risks models, with death from other causes treated as a competing event, and risk factors for death were identified using {C}ox models. {R}esults. {A}t {ART} initiation, 670 children (55% female) had a median age of 6.4 years (interquartile range, 2.0-9.6), body mass index-for-age z-score -0.8 (-1.9 to 0.0), {HIV} ribonucleic acid viral load 5.1 log(10) copies/m{L} (4.6-5.6), and {CD}4 9% (3-17). {M}edian duration of follow-up was 7.7 years. {T}uberculosis incidence was 7 per 1000 {PYFU} (95% confidence interval [{CI}], 5-11) and decreased with {ART} duration. {L}ower age-adjusted hemoglobin, hematocrit, and {CD}4 at {ART} initiation were associated with a higher risk of incident tuberculosis. {O}f the 30 incident tuberculosis cases, 9 died. {D}iagnosis of incident tuberculosis was associated with mortality (unadjusted hazard ratio = 10.2, 95% {CI} = 4.8-21.5, {P}<.001 and adjusted hazard ratio = 5.4, 95% {CI} = 2.5-11.7, {P}<.001). {C}onclusions. {I}ncident tuberculosis was strongly associated with mortality. {CD}4 counts or hemoglobin or hematocrit levels may prompt clinicians to consider a possible tuberculosis infection.},
  keywords = {children ; {HIV} ; incidence ; mortality ; tuberculosis ; {THAILANDE}},
  booktitle = {},
  journal = {{J}ournal of the {P}ediatric {I}nfectious {D}iseases {S}ociety},
  volume = {6},
  numero = {2},
  pages = {161--167},
  ISSN = {2048-7193},
  year = {2017},
  DOI = {10.1093/jpids/piw090},
  URL = {https://www.documentation.ird.fr/hor/fdi:010071418},
}