HIV and childhood tuberculosis: the way forward.

Tuberculosis has been a major cause of morbidity and mortality in under-resourced communities. By causing progressive immunodeficiency, the human immunodeficiency virus (HIV) increases susceptibility to tuberculosis in an already vulnerable community. Similarities in clinical presentation and radiological appearance contribute to diagnostic difficulties, as even in the absence of HIV childhood tuberculosis is not easy to diagnose. The majority of studies thus far have been descriptive and often cross-sectional, but have defined the extent of this complex interaction. There is now a need to undertake prospective diagnostic, therapeutic and prevention studies. An emerging concern is how to integrate antiretroviral with anti-tuberculosis treatment and to explore whether lessons learned in tuberculosis can support antiretroviral therapy. Interactions between therapies for both conditions also need careful study.