PROFILE OF TUBERCULOSIS IN HUMAN IMMUNODEFICIENCY VIRUS INFECTION CHILDREN IN BANDUNG AREA, INDONESIA

Heda Melinda D. Nataprawira*, Djatnika Setiabudi**, Adi Utomo Suardi*, Sri Sudarwati*, Anggraini Alam**, Masayu Amanda Ledika*** *Respirology Division, **Infection and Tropical Diseases Division, ***Pediatric Fellow Department of Child Health, Universitas Padjadjaran, Hasan Sadikin General Hospital, Indonesia Background and Aims: Tuberculosis (TB) is one of the leading cause of morbidity and mortality in children with human immunodeficiency virus (HIV) infection with 11% coinfection burden in South East Asia. In West Java, 163 (2.9%) HIV infected patients were children. Many status conditions of them were poorly reported. The objective of the study is to describe the profile of TB-HIV co-infection among children in Bandung area in Indonesia. Methods: A prospective study was conducted by reviewing documented TB-HIV registry (B20) admitted in pediatric ward of Hasan Sadikin Hospital, Bandung started 2005 until mid 2011. Clinical and laboratory, radiology profiles and parental HIV status were reported. Results: Ninety-eight HIV children presented equally distributed gender and 55% lived in urban area. There were increasing of HIV children documented in each year and most of them (69%) in clinical stage 3-4. Seventy percent children have TB co-infection. History of contacts with adults TB was identified in 52% children. Severe malnutrition, prolonged fever and chronic cough identified in 62%, 71% and 24% children, respectively. Positive tuberculin test was found in one third. BCG immunization was found in 90%. Only one had positive acid-fast bacilli. Chest radiography showed 76% suggesting TB. Milliary TB was diagnosed in one child. Positive parental HIV status only can be identified in 12% children. Conclusions: A high prevalence of TB among HIV-infected children. Its noted that most children admitted with advanced clinical profiles. In countries with high burden of TB, children should be mandatory for HIV testing.