Salvadori, NicolasNgo-Giang-Huong, NicoleDuclercq, ChloéKanjanavanit, SuparatNgampiyaskul, ChaiwatTechakunakorn, PornchaiPuangsombat, AcharaFigoni, JulieMary, Jean-YvesCollins, Intira J.Cressey, Tim R.Le Cœur, SophieSirirungsi, WasnaLallemant, MarcMcIntosh, KennethJourdain, Gonzague2018-05-302017Salvadori, N., N. Ngo-Giang-Huong, C. Duclercq, S. Kanjanavanit, C. Ngampiyaskul, P. Techakunakorn, A. Puangsombat, et al. 2017. “Incidence of Tuberculosis and Associated Mortality in a Cohort of Human Immunodeficiency Virus-Infected Children Initiating Antiretroviral Therapy.” Journal of the Pediatric Infectious Diseases Society 6 (2): 161-167. doi:10.1093/jpids/piw090. http://dx.doi.org/10.1093/jpids/piw090.http://nrs.harvard.edu/urn-3:HUL.InstRepos:37068011Abstract Background. We assessed the incidence of tuberculosis, risk factors for tuberculosis, and the contribution of tuberculosis on mortality in a large cohort of human immunodeficiency virus (HIV)-infected children <15 years of age initiating first-line antiretroviral therapy (ART) between 1999 and 2012 in Thailand, one of the 22 high tuberculosis burden countries. Methods. A physician reviewed and classified tuberculosis cases. Incidence was the number of children with incident tuberculosis, defined as a first or recurrent tuberculosis diagnosis >30 days after ART initiation, divided by the total person-years of follow-up (PYFU). Risk factors for incident tuberculosis were identified using Fine and Gray’s competing risks models, with death from other causes treated as a competing event, and risk factors for death were identified using Cox models. Results. At ART initiation, 670 children (55% female) had a median age of 6.4 years (interquartile range, 2.0–9.6), body mass index-for-age z-score −0.8 (−1.9 to 0.0), HIV ribonucleic acid viral load 5.1 log10 copies/mL (4.6–5.6), and CD4 9% (3–17). Median duration of follow-up was 7.7 years. Tuberculosis incidence was 7 per 1000 PYFU (95% confidence interval [CI], 5–11) and decreased with ART duration. Lower age-adjusted hemoglobin, hematocrit, and CD4 at ART initiation were associated with a higher risk of incident tuberculosis. Of the 30 incident tuberculosis cases, 9 died. Diagnosis of incident tuberculosis was associated with mortality (unadjusted hazard ratio = 10.2, 95% CI = 4.8–21.5, P < .001 and adjusted hazard ratio = 5.4, 95% CI = 2.5–11.7, P < .001). Conclusions. Incident tuberculosis was strongly associated with mortality. CD4 counts or hemoglobin or hematocrit levels may prompt clinicians to consider a possible tuberculosis infection.en-USchildrenHIVincidencemortalitytuberculosis.Journal Article2018-05-3010.1093/jpids/piw090