Disseminated Tuberkulosis  in a 4-Year Old HIV Infected Boy with Multiple Comorbidities

Ricky Wibisono; Magdalena Sidhartani; MM DEAH Hapsari

doi:10.35582/ijcpch.v1i2.11

Ricky Wibisono Departement of child health, Faculty of Medicine, Diponegoro University
Magdalena Sidhartani Department of Child Health, Faculty of Medicine, Diponegoro University
MM DEAH Hapsari Department of Child Health, Faculty of Medicine, Diponegoro University

DOI: https://doi.org/10.35582/ijcpch.v1i2.11

Keywords: HIV, tuberculosis, hepatitis C, severe malnutrition

Abstract

Background: HIV infections is a major health problem for pediatric population and often had many comorbidities which make the case difficult to manage.

Aim: To emphasis the need of interdisciplinary collaboration to manage HIV infection successfully.

Case: A 4 years old boy with clinical stage IV of HIV with disseminated tuberculosis, HCV infection, severe malnutrition, hypercalcemia, anemia and its comorbidities. The patient was \treated with antiretroviral therapy, anti-tuberculosis therapy, cotrimoxazole prophylaxis, nutritional support, and surgical interventions. During inpatient and outpatient care, the patient was assessed and treated by team consist of pediatricians (infection, immunology, nutrition and respirology division), surgeons (pediatric and orthopedic), and physiotherapist. The patient discharged after 27 days of inpatient care.

Discussion: HIV infection in children is very complex due to many comorbidities. HIV-TB coinfection make poorer prognosis and the need of regiment modification. HCV and HIV share a same transmission that make coinfection of both viruses often occurs. Compared with HIV-uninfected patients, HIV-infected patients have higher HCV viral loads, lower rate of spontaneous HCV clearance, and accelerated liver disease. HIV infection and malnutrition occur together in children, and malnutrition also increases the frequency and severity of infections and delays recovery. Those conditions need to be treated comprehensively for successful treatment.

Conclusion: A 4 years old HIV infected boy with disseminated tuberculosis, severe malnutrition, abscess, and hepatitis C infection was successfully treated multidisciplinary by giving ART, anti-tuberculosis drug, adequate nutrition, and other infection eradication.