7.1.1. Introduction

Children and adolescents living with HIV have an increased risk of TB exposure, infection, progression to disease, and TB-related morbidity and mortality. This risk is influenced by the degree of immune suppression. Childhood HIV infection is particularly common in settings where antenatal HIV prevalence is high and interventions for prevention of vertical transmission are not implemented widely. In these settings, the prevalence of HIV is particularly high among infants and young children, an age group that is also at risk for TB.

In regions endemic for TB and HIV, TB is common in children living with HIV, and HIV infection is common in children with TB. HIV testing is recommended to be routinely offered to all children and adolescents with presumed or diagnosed TB (167). In 2020, of the 226 000 TB-related deaths in children, 21 000 (9%) were in children living with HIV (1).

Of 210 000 children notified in 16 high TB/HIV burden countries with TB in 2020, 143 000 (68%) had an HIV test result recorded. Of these, 7720 tested positive for HIV (5.4%). Of the 7720 children who were found to have TB/HIV coinfection, 6653 (86%) were receiving ART (1).

Box 7.1

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