SynthesisThorax2017
The impact of HIV and antiretroviral therapy on TB risk in children: a systematic review and meta-analysis.
Synthesis in Thorax, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06239337 (Evaluation of Xpert MTB/RIF Ultra in Stools and Urine to Improve Tuberculosis Diagnosis in Children), which is not on this map. Cited by 57 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of Xpert MTB/RIF Ultra in Stools and Urine to Improve Tuberculosis Diagnosis in Children
Who cites it
57 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Tuberculosis in children who are HIV-exposed uninfected.AIDS (London, England) · 2026Pooled it
- Risk factors for the development of tuberculosis among the pediatric population: a systematic review and meta-analysis.European journal of pediatrics · 2023Pooled it
- Pharmacokinetics of antiretroviral and tuberculosis drugs in children with HIV/TB co-infection: a systematic review.The Journal of antimicrobial chemotherapy · 2020Pooled it
- Effectiveness of interventions for reducing TB incidence in countries with low TB incidence: a systematic review of reviews.European respiratory review : an official journal of the European Respiratory Society · 2019Pooled it
- Bridging to Paediatric Dosing: Relative Bioavailability of Suspended Rifapentine and Isoniazid in an Open-Label Randomized Trial in Adults on Tuberculosis Preventive Therapy.Clinical pharmacokinetics · 2025Trial
- Pharmacokinetics and safety of dolutegravir in children receiving rifampicin tuberculosis treatment in South Africa (ORCHID): a prospective cohort study.The lancet. HIV · 2025Trial
- Cost-effectiveness of integrating paediatric tuberculosis services into child healthcare services in Africa: a modelling analysis of a cluster-randomised trial.BMJ global health · 2024Trial
- Clinical Outcomes in Children With Human Immunodeficiency Virus Treated for Nonsevere Tuberculosis in the SHINE Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- Twice-Daily Dosing of Dolutegravir in Infants on Rifampicin Treatment: A Pharmacokinetic Substudy of the EMPIRICAL Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- Dolutegravir twice-daily dosing in children with HIV-associated tuberculosis: a pharmacokinetic and safety study within the open-label, multicentre, randomised, non-inferiority ODYSSEY trial.The lancet. HIV · 2022Trial
- Linking Children and Adolescents With TB Disease to HIV Services in 16 PEPFAR-supported High TB/HIV-Burden Countries in Sub-Saharan Africa, October 2018-September 2022.The Pediatric infectious disease journal · 2026Article
- Understanding ischemia in children with tuberculous meningitis (iThemba): a protocol paper.BMC pediatrics · 2026Article
- Article
- Beyond HIV: Prevalence and Interaction of Immunosuppressive Conditions in Patients with Tuberculosis.Annals of African medicine · 2026Observational
- Predictors of nutritional recovery among undernourished adults on antiretroviral therapy treated with ready-to-use therapeutic food at public health facilities in Southeast Ethiopia: a retrospective cohort study.BMC infectious diseases · 2025Article
- Tuberculosis disease among people with HIV: therapeutic advances.The lancet. HIV · 2025Review
- High Incidence of Tuberculosis in Young Children Living With HIV in the Western Cape, South Africa.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Age-specific relationship between HIV and TB treatment outcomes in the West Region of Cameroon: a cross-sectional study.BMC infectious diseases · 2025Article
- Factors driving adolescent tuberculosis incidence by age and sex in 30 high-tuberculosis burden countries: a mathematical modelling study.BMJ global health · 2025Article
- Transiently boosting Vγ9+Vδ2+ γδ T cells early in Mtb coinfection of SIV-infected juvenile macaques does not improve Mtb host resistance.Infection and immunity · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundChildren (<15 years) are vulnerable to TB disease following infection, but no systematic review or meta-analysis has quantified the effects of HIV-related immunosuppression or antiretroviral therapy (ART) on their TB incidence.
objectivesDetermine the impact of HIV infection and ART on risk of incident TB disease in children.
methodsWe searched MEDLINE and Embase for studies measuring HIV prevalence in paediatric TB cases ('TB cohorts') and paediatric HIV cohorts reporting TB incidence ('HIV cohorts'). Study quality was assessed using the Newcastle-Ottawa tool. TB cohorts with controls were meta-analysed to determine the incidence rate ratio (IRR) for TB given HIV. HIV cohort data were meta-analysed to estimate the trend in log-IRR versus CD4%, relative incidence by immunological stage and ART-associated protection from TB.
results42 TB cohorts and 22 HIV cohorts were included. In the eight TB cohorts with controls, the IRR for TB was 7.9 (95% CI 4.5 to 13.7). HIV-infected children exhibited a reduction in IRR of 0.94 (95% credible interval: 0.83-1.07) per percentage point increase in CD4%. TB incidence was 5.0 (95% CI 4.0 to 6.0) times higher in children with severe compared with non-significant immunosuppression. TB incidence was lower in HIV-infected children on ART (HR: 0.30; 95% CI 0.21 to 0.39). Following initiation of ART, TB incidence declined rapidly over 12 months towards a HR of 0.10 (95% CI 0.04 to 0.25).
conclusionsHIV is a potent risk factor for paediatric TB, and ART is strongly protective. In HIV-infected children, early diagnosis and ART initiation reduces TB risk. TRIAL REGISTRATION NUMBER: CRD42014014276.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.