{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T19:05:58Z","timestamp":1776107158370,"version":"3.50.1"},"reference-count":0,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["int j tuberc lung dis"],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"<jats:p><jats:bold>BACKGROUND:<\/jats:bold> Tuberculosis (TB) is the leading opportunistic infection in children with human immunodeficiency virus (HIV), but is uncommon in low prevalence regions. We aim to describe the changing epidemiology and clinical presentation of TB-HIV co-infection in a cohort of HIV-infected\n children in Spain.<jats:bold>METHODS:<\/jats:bold> Children diagnosed with TB between 1995 and 2016 in the paediatric HIV cohort were identified. The incidence and clinical presentation were compared in three periods: 1995\u20131999 (P1, before initiation of combined antiretroviral therapy, cART), 2000\u20132009\n (P2, increase in immigration), and 2010\u20132016 (P3, decrease in immigration).<jats:bold>RESULTS:<\/jats:bold> We included 29 TB cases among 1183 children aged &lt;18 years (2.4%, 243\/100\u2009000 person-years). The proportion was stable in P1 and P2 (1.3%), but decreased in P3 (0.8%). The median\n age at TB diagnosis was 6.4 years (IQR 4\u201310.6); most children in P3 were aged &gt;10 years (20% vs. 23.1% vs. 83.3%, <jats:italic>P<\/jats:italic> = 0.01). TB was diagnosed at HIV presentation in 11\/29 children (37.9%). Foreign-born children accounted for respectively 0%, 8% and 67% of the total number of\n children in each period (<jats:italic>P<\/jats:italic> \u2264 0.0001). One third had extrapulmonary TB; four children died (13.8%).<jats:bold>CONCLUSION:<\/jats:bold> In our cohort, the incidence of TB-HIV co-infection decreased with decline in immigration. In regions with adequate cART coverage and low TB transmission, paediatric\n TB-HIV coinfection is uncommon, but associated with significant morbidity. Strategies for TB surveillance, diagnosis and treatment in this vulnerable population should be reinforced.<\/jats:p>","DOI":"10.5588\/ijtld.19.0237","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T00:46:08Z","timestamp":1585615568000},"page":"303-309","source":"Crossref","is-referenced-by-count":3,"title":["Tuberculosis in a Spanish cohort of children living with HIV: the CHOTIS study (Childhood HIV &amp; TB study)"],"prefix":"10.5588","volume":"24","author":[{"given":"E. M.","family":"L\u00f3pez-Medina","sequence":"first","affiliation":[{"name":"Department of Pediatric Infectious Diseases, University Hospital La Fe, Valencia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Sainz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, University Hospital La Paz, and La Paz Research Institute (IdiPAZ), Madrid"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Jim\u00e9nez","family":"de Ory","sequence":"additional","affiliation":[{"name":"University Hospital Gregorio Mara\u00f1\u00f3n and Gregorio Mara\u00f1\u00f3n Research Institute (IiSGM), CoRISpe, Madrid"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. J.","family":"Mellado-Pe\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, University Hospital La Paz, and La Paz Research Institute (IdiPAZ), Madrid"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. I.","family":"Gonz\u00e1lez-Tom\u00e9","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases and HIV Unit, University Hospital 12 de Octubre and Research Institute (I+12), Madrid"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. Colino","family":"Gil","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit, Complejo Hospitalario Insular Materno Infantil Las Palmas, Las Palmas de Gran Canaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. Vallmanya","family":"Cucurull","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit, University Hospital Arnau de Vilanova, Lleida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Falc\u00f3n","family":"Neyra","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases, Immunology and Rheumatology Unit, University Hospital Virgen del Roc\u00edo, and Instituto de Biomedicina de Sevilla (IBiS), Sevilla"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. A.","family":"Frick","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Mart\u00ednez-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Pediatrics Department; University Hospital Ni\u00f1o Jes\u00fas, Madrid"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. G. Andr\u00e9s","family":"Andr\u00e9s","sequence":"additional","affiliation":[{"name":"Pediatrics Department, Complejo Asistencial Universitario de Le\u00f3n, Le\u00f3n"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Bustillo","family":"Alonso","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit; Miguel Servet Pediatric Hospital, Zaragoza"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. Guerrero","family":"Laleona","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit; Miguel Servet Pediatric Hospital, Zaragoza"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. M\u00e9ndez","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit, Hospital Germans Trias y Pujol, Universitat Aut\u00f2noma de Barcelona, Badalona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. Collado","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Pediatrics Department, Hospital Cl\u00ednico Lozano Blesa, Universidad Zaragoza, Zaragoza"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. T. Ramos","family":"Amador","sequence":"additional","affiliation":[{"name":"Pediatrics Department, Cl\u00ednico San Carlos University Hospital and Research Institute (IDISSC), Universidad Complutense de Madrid, Madrid"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. L. Navarro","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Pediatrics Department, University Hospital Gregorio Mara\u00f1\u00f3n and Gregorio Mara\u00f1\u00f3n Research Institute (IiSGM), Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Santiago-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Pediatrics Department, University Hospital Gregorio Mara\u00f1\u00f3n and Gregorio Mara\u00f1\u00f3n Research Institute (IiSGM), Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"TB-HIV working group of the National Network","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"National Pediatric TB Network (pTBred) of Spa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Translational Research Network in Pediatric I","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3554","container-title":["The International Journal of Tuberculosis and Lung Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/iuatld\/ijtld\/2020\/00000024\/00000003\/art00011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,8]],"date-time":"2020-04-08T03:40:17Z","timestamp":1586317217000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.5588\/ijtld.19.0237"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,1]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3,1]]}},"alternative-id":["1027-3719(20200301)24:3L.303;1-"],"URL":"https:\/\/doi.org\/10.5588\/ijtld.19.0237","relation":{},"ISSN":["1027-3719"],"issn-type":[{"value":"1027-3719","type":"print"}],"subject":[],"published":{"date-parts":[[2020,3,1]]}}}