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Master Thesis

Tuberculose chez l’enfant infecté par le VIH en Ile-de-France : diagnostic et prise en charge à l’ère des multithérapies antirétrovirales

Abstract : Introduction: Co-infection tuberculosis (TB)/HIV is rare in children in France. The objective of this study is to describe its management in a developed country in the era of highly active antiretroviral treatment (HAART). Methods: We performed a retrospective file review of all HIV-infected children < 18 years old who have been treated for TB disease between 01/01/2003 and 05/01/2014 in 3 pediatric university hospitals in Paris. The impact of therapeutic drug monitoring (TDM) in the management was studied. Results: Data from 20 children were analyzed. 80% were born abroad and the diagnosis of the 2 infections was made simultaneously in 50% of cases. The median CD4 cell count at TB diagnosis was 500 CD4/mm3 [range 0-2060]. 18 of 20 patients had an intra-thoracic involvement and 11 an extra-thoracic involvement. TB diagnosis was confirmed microbiologically in 30% of cases, the tuberculin skin test was positive in 50% of cases and interferon-gamma release assays in 69% of cases. 1 case of immune reconstitution inflammatory syndrome has been reported. All children have simultaneously received anti-tuberculous therapy (ATT) and HAART and TDM was used in 85% of cases. Dosages of ATT were found low in 44% of cases and led to frequent dose adjustments. All children are cured of TB episode. Conclusions: The management of co-infection TB / HIV in children is complex and requires a specialized team. The TDM of ATT and HAART are an important aid and should systematically be made.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01229425
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Submitted on : Monday, November 16, 2015 - 4:02:21 PM
Last modification on : Friday, March 27, 2020 - 2:26:12 AM
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  • HAL Id : dumas-01229425, version 1

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Lou Le Mouel. Tuberculose chez l’enfant infecté par le VIH en Ile-de-France : diagnostic et prise en charge à l’ère des multithérapies antirétrovirales. Médecine humaine et pathologie. 2015. ⟨dumas-01229425⟩

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