Tuberculosis : opportunities and challenges for the 90-90-90 targets in HIV-infected children
Date
2015-12-02
Journal Title
Journal ISSN
Volume Title
Publisher
International AIDS Society
Abstract
Introduction: In 2014 the Joint United Nations Programme on HIV/AIDS defined the ambitious 90 90 90 targets for 2020, in
which 90% of people living with HIV must be diagnosed, 90% of those diagnosed should be on sustained therapy and 90% of
those on therapy should have an undetectable viral load. Children are considered to be a key focus population for these targets.
This review will highlight key components of the epidemiology, prevention and treatment of tuberculosis (TB) in HIV-infected
children in the era of increasing access to antiretroviral therapy (ART) and their relation to the 90 90 90 targets.
Discussion: The majority of HIV-infected children live in countries with a high burden of TB. In settings with a high burden of
both diseases such as in sub-Saharan Africa, up to 57% of children diagnosed with and treated for TB are HIV-infected. TB results
in substantial morbidity and mortality in HIV-infected children, so preventing TB and optimizing its treatment in HIV-infected
children will be important to ensuring good long-term outcomes. Prevention of TB can be achieved by increasing access to
ART to both children and adults, and appropriate provision of isoniazid preventative therapy. Co-treatment of HIV and TB is
complicated by drug-drug interactions particularly due to the use of rifampicin; these may compromise virologic outcomes if
appropriate corrective actions are not taken. There remain substantial operational challenges, and improved integration of
paediatric TB and HIV services, including with antenatal and routine under-five care, is an important priority.
Conclusions: TB may be an important barrier to achievement of the 90 90 90 targets, but specific attention to TB care in
HIV-infected children may provide important opportunities to enhance the care of both TB and HIV in children.
Description
CITATION: Rabie, H., Frigati, L., Hesseling, A. C. & Garcia-Prats, A. J. 2015. Tuberculosis : opportunities and challenges for the 90-90-90 targets in HIV-infected children. Journal of the International AIDS Society, 18(Suppl 6):20236, doi:10.7448/IAS.18.7.20236.
The original publication is available at http://www.jiasociety.org
The original publication is available at http://www.jiasociety.org
Keywords
Tuberculosis in children -- Epidemiology, HIV infections -- South Africa -- Prevention, Tuberculosis in children -- Treatment, 90-90-90 target, HIV-positive children -- South Africa, Antiretroviral agents, Joint United Nations Programme on HIV/AIDS
Citation
Rabie, H., Frigati, L., Hesseling, A. C. & Garcia-Prats, A. J. 2015. Tuberculosis : opportunities and challenges for the 90-90-90 targets in HIV-infected children. Journal of the International AIDS Society, 18(Suppl 6):20236, doi:10.7448/IAS.18.7.20236.