Tuberculosis in children who are HIV-exposed uninfected.
Jeffrey I Campbell, Ojasvi Vachharajani, Melanie M Dubois et al.
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In 30 seconds
This systematic review and meta-analysis examined tuberculosis (TB) infection and disease risk in children who are HIV-exposed uninfected (cHEU) compared to HIV-unexposed uninfected children (cHUU) and children with HIV (CWH). The analysis included 26 studies, revealing that cHEU have a similar risk of TB infection and disease as cHUU, but a lower risk of TB disease compared to CWH (RR 0.29; 95% CI 0.16-0.51).
Key findings
- cHEU have a similar prevalence of TST/IGRA positivity compared to cHUU (RR 1.26; 95% CI 0.92-1.72).
- cHEU show a lower cumulative incidence of TB disease compared to CWH (RR 0.29; 95% CI 0.16-0.51).
- No significant difference in TST/IGRA positivity between cHEU and CWH (RR 0.24; 95% CI 0.02-3.91).
Why it matters
Understanding the TB risk in cHEU is crucial for developing targeted prevention strategies in high-burden settings, especially since these children represent a significant population at risk due to maternal HIV exposure.
What to keep in mind
Findings were limited by a lack of studies beyond infancy and a small number of studies overall.