Predictive Model Approach to HIV TB Co-infection in Vertical Transmission

Abstract

Tuberculosis (TB) is the most common AIDS-defining opportunistic infection worldwide (Bauer AL et al: Math Mode Nat Phenom 3(Suppl 7):229–266, 2008; Gakkhar S, Chavda N: J Appl Math Comput 218:9261–9270, 2012). HIVTB co-infection is becoming a global emergency especially in India (Joyce KN: Appl Math Sci 9(Suppl 105):5215–5233. ID gov. https://www.aids.gov/hiv-aids-basics/. Retrieved 12/31/2015, 2015; Harries AD et al: Lancet 357(9267):1519–1529, 2001). Its diagnosis is notoriously challenging in countries, with poor resources and with limited diagnostic facilities. Defined AIDS as characterized by a number of opportunistic infections (OIs), which are responsible for high morbidity and mortality (Central TB Division: Directorate general of health services, RNTCP status report. TB India, New Delhi, 2003; Krischner D et al: Dynamics of co-infection with M. tuberculosis and HIV-1. Theor Popul Biol 55:94–109, 1999; Kulshershtha R, Nigam M, Sarin S, Mathur A: Indian J Med Microbiol 15:79–81, 1991). In fact, even before the discovery of the causative virus, cases of AIDS were defined as those having certain opportunistic infections (OIs) (Joyce KN: Appl Math Sci 9(Suppl 105):5215–5233. ID gov. https://www.aids.gov/hiv-aids-basics/. Retrieved 12/31/2015, 2015). The spectrum and distribution of opportunistic infections in AIDS patients is ever-expanding. This spectrum varies from continent to continent as also between children and adults (Lange JMA et al: AIDS 18(suppl 3):69–S74, 2004; Lawn SD, Bekker L, Miller RF: Lancet Infect Dis 5(6):361–373, 2005; Mahe D, Harries A, Haileyesus G et al: Trop Med Int Health 21(Suppl 8):734–742, 2005. There are differences in the pattern of opportunistic infections (OIs) in AIDS patients depending upon the risk group. From the limited studies conducted, it is quite apparent that tuberculosis is the single most important opportunistic infection associated with AIDS in our country. It is estimated that an HIV-infected individual is six times at higher risk of acquiring tuberculosis than an HIV-negative individual. In AIDS patients, the incidence of extrapulmonary tuberculosis (EPTB) increases and that of smear positive pulmonary tuberculosis decreases (PTB) making the diagnosis of the disease much more difficult, unless good diagnostic tools are available. In the current chapter, the prevalence, pattern, and risk factors for HIV TB co-infection among infected children are discussed.